Provider Demographics
NPI:1336216399
Name:HUNT, CLIFTON H (MD)
Entity Type:Individual
Prefix:
First Name:CLIFTON
Middle Name:H
Last Name:HUNT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5153 W WOODMILL DR
Mailing Address - Street 2:SUITE 18
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-4067
Mailing Address - Country:US
Mailing Address - Phone:302-999-7898
Mailing Address - Fax:302-633-0837
Practice Address - Street 1:5153 W WOODMILL DR
Practice Address - Street 2:SUITE 18
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-4067
Practice Address - Country:US
Practice Address - Phone:302-999-7898
Practice Address - Fax:302-633-0837
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2015-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0001876207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE510261222OtherTAX ID
DE0000303301Medicaid
DE510261222OtherBLUE CROSS BLUE SHIELD DELAWARE
DE510261222OtherTAX ID
DE108022Medicare ID - Type Unspecified