Clifford L Weldon M D P L C

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

CW054557 Issued in MI

Legal business name

CLIFFORD L WELDON M D P L C

Practice address

15945 19 Mile Rd Ste 202
Clinton Township, MI 48038-1147

Phone

(586) 285-9270

Fax

(586) 285-9271

NPI assigned

Jun 16, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Clifford L Weldon, MD

Title

Physician/Owner

Phone

(586) 285-9270

Specialties & licenses 1

Addresses

Other identifiers 9

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1276646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627430400000",
    "number": "1912228743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30695 LITTLE MACK AVE STE 500",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480661772",
            "telephone_number": "586-285-9270",
            "fax_number": "586-285-9271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15945 19 MILE RD STE 202",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381147",
            "telephone_number": "586-285-9270",
            "fax_number": "586-285-9271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLIFFORD L WELDON M D P L C",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-16",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A",
        "authorized_official_last_name": "WELDON",
        "authorized_official_first_name": "CLIFFORD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "586-285-9270",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "CW054557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOLINA",
            "identifier": "QMXPR0020661",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "0500966",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "CW054557",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPS",
            "identifier": "7001298",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "M-006492",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN",
            "identifier": "P87524",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TOTAL HEALTHCARE",
            "identifier": "0166726",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1528194545",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OMNICARE",
            "identifier": "21606",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Corbin Cleary, MD
• Myrsha Clemons, LLMSW
• Clinton Care Pharmacy LLC
• Clinton Diagnostic, LLC
• Clinton Fitness Inc (Powerhouse Gym Macomb)
• Clinton Medical Pharmacy (mgt investments enterprises llc)
• Clinton Pain and Anesthesia PLC

• Cardiovascular Disease Physician in Clinton Township, MI
• Providers in Clinton Township, MI by specialty
• Cardiovascular Disease Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.