Vincent, Clarence J

Vincent, Clarence J is an individual health care provider with primary practice located at 952 Seton Dr , Cumberland MD 21502-1950. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Vincent, Clarence J can be contacted via phone (301) 777-3522.

Contact Information

Primary practice address
952 Seton Dr Cumberland MD 21502-1950
Fax: (301) 777-1902
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X D0017474 Maryland

Profile Details

NPI number 1457354516
LBN Legal business name Vincent, Clarence J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2005
Last updated Jul 25th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457354516 NPPES
West Virginia Other 001717208 MT ST BLUE SHIELD
West Virginia Other J2490005 MT ST BLUE SHIELD
West Virginia MEDICAID 1012103550001 MT ST BLUE SHIELD
West Virginia MEDICAID 0086105000 MT ST BLUE SHIELD
West Virginia MEDICAID 411501500 MT ST BLUE SHIELD
West Virginia Other J2480005 MT ST BLUE SHIELD
West Virginia Other P00139754 MT ST BLUE SHIELD

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