Provider Demographics
NPI:1174709109
Name:NOWELL, CLIFTON M (DO, MS)
Entity type:Individual
Prefix:DR
First Name:CLIFTON
Middle Name:M
Last Name:NOWELL
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Gender:M
Credentials:DO, MS
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Mailing Address - Street 1:2261 PHILADELPHIA DR
Mailing Address - Street 2:ATTN: MEDICAL EDUCATION DEPARTMENT
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45406
Mailing Address - Country:US
Mailing Address - Phone:937-734-4141
Mailing Address - Fax:937-277-7249
Practice Address - Street 1:2222 PHILADELPHIA DR
Practice Address - Street 2:ATTN: MEDICAL EDUCATION DEPARTMENT
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45406-1813
Practice Address - Country:US
Practice Address - Phone:937-734-4141
Practice Address - Fax:937-277-7249
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-22
Last Update Date:2022-03-16
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Provider Licenses
StateLicense IDTaxonomies
HIDOS-1201207Q00000X, 2083A0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine