DR. CLINTON DAVID PROTACK (NPI# 1952563801) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952563801 |
| Entity Type | Individual |
| Full Name | DR. CLINTON DAVID PROTACK |
| Credential | MD |
| Practice Address |
520 Upper Chesapeake Dr Ste 306 Bel Air MD 21014-4375 |
| Practice Telephone | 4108792006 |
| Practice Fax Number | 4108790428 |
| Mailing Telephone | 4108792006 |
| Mailing Fax Number | 4108790428 |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2019-09-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
D87273 | MD | Allopathic & Osteopathic Physicians |
| Street Address |
520 UPPER CHESAPEAKE DR STE 306 |
| City | BEL AIR |
| State | MD |
| Zip Code | 21014-4375 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760686257 | Michael J Osgood | Surgery | 520 Upper Chesapeake Dr Ste 306, Bel Air, MD 21014-4375 | 2007-06-11 |
| 1326519851 | Shelby Elise Norris | Physician Assistant | 520 Upper Chesapeake Dr Ste 306, Bel Air, MD 21014-4375 | 2018-12-10 |
| 1336642586 | Kaylie Gonze | Physician Assistant | 520 Upper Chesapeake Dr Ste 306, Bel Air, MD 21014-4375 | 2018-03-14 |
| 1194239996 | Vsa Surgery Center LLC | Surgery | 520 Upper Chesapeake Dr Ste 306, Bel Air, MD 21014-4375 | 2017-12-01 |
| 1639425473 | Anna Morgan Snow Suarez | Physician Assistant | 520 Upper Chesapeake Dr Ste 306, Bel Air, MD 21014-4375 | 2012-07-31 |
| 1467710822 | Donald Joseph Hahn | Surgery | 520 Upper Chesapeake Dr Ste 306, Bel Air, MD 21014-4375 | 2012-04-24 |
| 1780847400 | Micah Girotti | Surgery | 520 Upper Chesapeake Dr Ste 306, Bel Air, MD 21014-4375 | 2008-07-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932757713 | Rebecca Gavin | Social Worker | 221 Maitland St Ste 204, Bel Air, MD 21014 | 2019-08-26 |
| 1790348563 | Iql Behavioral Health Services LLC | Community/Behavioral Health | 1003 Red Pump Road, Bel Air, MD 21014 | 2019-04-17 |
| 1700355351 | Barbara Ann Melton-jones | Counselor | 120 S. Hays St., Bel Air, MD 21014 | 2018-11-13 |
| 1306327945 | Donald David Fleming | Counselor | Dave Fleming, 418 S Main Street, Bel Air, MD 21014 | 2018-08-22 |
| 1003396847 | Michael Smith, Dpt LLC | Physical Therapist | 10 South Hays Street, Bel Air, MD 21014 | 2018-08-21 |
| 1467942987 | The Caring Connection, Inc | Adult Companion | 304 Vale Road, Bel Air, MD 21014 | 2018-05-10 |
| 1194220376 | Mc Counseling Inc | Social Worker | 336 S. Main Street, Suite 2 C-a, Bel Air, MD 21014 | 2018-03-28 |
| 1861997678 | Harford X-ray Services LLC | Radiology | 615 W Macphail Rd Ste 106b, Bel Air, MD 21014 | 2018-03-26 |
| 1386143964 | Lucy Huiyu Tong | Nurse Practitioner | Potomac Physicians, 104 Plumtree Road, Bel Air, MD 21014 | 2018-02-08 |
| 1124561238 | Children's National Health System | Chronic Disease Hospital | 914 Cheswold Court, Bel Air, MD 21014 | 2016-11-21 |
| Find all providers in zip 21014 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760686257 | Michael J Osgood | Surgery | 520 Upper Chesapeake Dr Ste 306, Bel Air, MD 21014-4375 | 2007-06-11 |
| 1194239996 | Vsa Surgery Center LLC | Surgery | 520 Upper Chesapeake Dr Ste 306, Bel Air, MD 21014-4375 | 2017-12-01 |
| 1467710822 | Donald Joseph Hahn | Surgery | 520 Upper Chesapeake Dr Ste 306, Bel Air, MD 21014-4375 | 2012-04-24 |
| 1215056254 | Richard A Bafford | Surgery | 520 Upper Chesapeake Dr, Suite 306, Bel Air, MD 21014-4339 | 2007-03-29 |
| 1295797769 | Roger E Schneider | Surgery | 520 Upper Chesapeake Dr, Suite 306, Bel Air, MD 21014-4339 | 2006-04-03 |
| 1548222912 | Vascular Surgery Associates, L.L.C. | Surgery | 520 Upper Chesapeake Dr, Suite 306, Bel Air, MD 21014-4339 | 2006-04-03 |
| 1538121983 | Mark D Gonze | Surgery | 520 Upper Chesapeake Dr, Suite 306, Bel Air, MD 21014-4339 | 2006-04-03 |
| 1124080585 | Peter J Mackrell | Surgery | 520 Upper Chesapeake Dr, Suite 306, Bel Air, MD 21014-4339 | 2006-04-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326678731 | Nova Vascular Specialists, LLC | Surgery | 1952 Pulaski Hwy Ste B-2, Edgewood, MD 21040-1658 | 2020-01-24 |
| 1033683339 | Vein and Vascular Institute of Central Maryland | Surgery | 1300 York Rd Ste 200, Lutherville, MD 21093-6090 | 2019-01-20 |
| 1932651312 | Elham Oumer | Surgery | 8730 Cherry Ln Ste 10, Laurel, MD 20707-6212 | 2016-11-01 |
| 1255742961 | Marta Vismer | Surgery | 19942 Gateshead Cir, Germantown, MD 20876-6311 | 2014-05-15 |
| 1023448305 | Samer Saiedy Md Gb LLC | Surgery | 1811 Crain Hwy S, Glen Burnie, MD 21061-5561 | 2013-11-22 |
| 1285077289 | Lucy Kupersmith | Surgery | 2002 Medical Pkwy Ste 502, Annapolis, MD 21401 | 2013-04-10 |
| 1316227150 | Joshua Dearing | Surgery | 7503 Surratts Rd Ste 208, Clinton, MD 20735-3358 | 2011-08-25 |
| 1861782492 | Norman Anthony Odyniec | Surgery | 9208 Levelle Dr, Chevy Chase, MD 20815-5604 | 2011-04-16 |
| 1730480872 | James F Mcguckin Md of Md Pa | Surgery | 3450 Old Washington Rd Ste 202, Waldorf, MD 20602-3250 | 2010-11-05 |
| 1194952796 | James M Salander, Md Pa | Surgery | 11119 Rockville Pile, #204, Rockville, MD 20852 | 2009-06-22 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.