Provider Demographics
NPI:1053395905
Name:CLIFFORD, CHRISTOPHER M (CRNA)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:M
Last Name:CLIFFORD
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 W COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-6129
Mailing Address - Country:US
Mailing Address - Phone:443-235-6853
Mailing Address - Fax:
Practice Address - Street 1:31519 WINTERPLACE PKWY STE 3
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-1894
Practice Address - Country:US
Practice Address - Phone:410-546-2500
Practice Address - Fax:443-250-2454
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-05
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR118456367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD403729400Medicaid
430061594OtherRAILROAD MEDICARE