Clifton Waters

Individual provider Active NPI Driver · Salisbury, MD

NPI 1750844940 · NPPES record last updated Apr 13, 2019

Key facts

NPI
1750844940
Entity type
Individual (NPI type 1)
Primary specialty
Driver 172A00000X
License
20190936 (VA)
Practice address
206 Davis St
Salisbury, MD 21804
Phone
(443) 614-9829
NPI assigned
Apr 13, 2019
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
20190936VAMDDriver

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X 20190936 VA Yes

Addresses

Primary practice location

206 Davis St
Salisbury, MD 21804

Mailing address

206 Davis St
Salisbury, MD 21804
Phone (443) 614-9829

Other identifiers

IdentifierTypeStateIssuer
0OtherMEDICAL TRANSPORTATION

Other providers in Salisbury, MD

All providers in Salisbury, MD · Driver in Maryland

Sources for this page

Verify at the official NPI Registry.