Provider Demographics
NPI:1457350555
Name:SOLOMON, CLIFFORD T (MD)
Entity type:Individual
Prefix:DR
First Name:CLIFFORD
Middle Name:T
Last Name:SOLOMON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 64584
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4584
Mailing Address - Country:US
Mailing Address - Phone:410-280-6568
Mailing Address - Fax:410-280-6515
Practice Address - Street 1:301 HOSPITAL DR
Practice Address - Street 2:SUITE 803
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-5803
Practice Address - Country:US
Practice Address - Phone:410-553-8160
Practice Address - Fax:410-553-8159
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0037668207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD752731400Medicaid
MD165790ZEZTMedicare PIN
MDF30223Medicare UPIN