Provider Demographics
NPI:1982673851
Name:SEWARD, CLIFFORD R (MD)
Entity Type:Individual
Prefix:MR
First Name:CLIFFORD
Middle Name:R
Last Name:SEWARD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5900 HILLANDALE DR STE 345
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30058-6803
Mailing Address - Country:US
Mailing Address - Phone:678-990-4480
Mailing Address - Fax:678-990-4481
Practice Address - Street 1:5900 HILLANDALE DR
Practice Address - Street 2:SUITE 345
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30058-3802
Practice Address - Country:US
Practice Address - Phone:678-990-4480
Practice Address - Fax:678-990-4481
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA029946207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000729462HMedicaid
GA18BDGGNMedicare PIN
GA000729462HMedicaid