Provider Demographics
NPI:1013485358
Name:CLINTON MEDICAL AND URGENT CARE LLC
Entity Type:Organization
Organization Name:CLINTON MEDICAL AND URGENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:CLOVER
Authorized Official - Middle Name:
Authorized Official - Last Name:SPRINGER
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:301-877-7700
Mailing Address - Street 1:9009 WOODYARD RD STE 101
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-4268
Mailing Address - Country:US
Mailing Address - Phone:301-877-7700
Mailing Address - Fax:
Practice Address - Street 1:9009 WOODYARD RD STE 101
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-4268
Practice Address - Country:US
Practice Address - Phone:301-877-7700
Practice Address - Fax:301-877-7701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-05
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty