Provider Demographics
NPI:1548459142
Name:CURTIS, CLIFFORD AUSTIN NELSON (MD)
Entity type:Individual
Prefix:DR
First Name:CLIFFORD
Middle Name:AUSTIN NELSON
Last Name:CURTIS
Suffix:
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:NORTH CAROLINA DEPARTMENT OF CORRECTIONS; 4287 BRAGG ST
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27699-0001
Mailing Address - Country:US
Mailing Address - Phone:919-733-4340
Mailing Address - Fax:
Practice Address - Street 1:NORTH CAROLINA DEPARTMENT OF CORRECTIONS; 4287 BRAGG ST
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27699-0001
Practice Address - Country:US
Practice Address - Phone:919-733-4340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-18
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC19344207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine