Provider Demographics
NPI:1972561843
Name:CLIFFORD, BERNARD D JR (MD)
Entity type:Individual
Prefix:
First Name:BERNARD
Middle Name:D
Last Name:CLIFFORD
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040-6612
Mailing Address - Country:US
Mailing Address - Phone:413-534-1124
Mailing Address - Fax:
Practice Address - Street 1:10 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-6612
Practice Address - Country:US
Practice Address - Phone:413-534-1124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2011-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA74396207RG0100X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3082059Medicaid
MA074396OtherTUFTS
MAJ11248OtherBCBS
MAAA141137OtherHPHC
MA074396OtherTUFTS