| NPI | 1619141462 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL WILLIAM CLISHAM Podiatrist 443-460-0127 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MD 00506) |
| Enumeration Date | 2008-04-14 |
| Last Update Date | 2008-06-06 |