Clair, Charles Malcolm
Clair, Charles Malcolm is an sole proprietor health care provider with primary practice located at 1071 Renee Ave , Pocatello ID 83201-2508. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Clair, Charles Malcolm can be contacted via phone (208) 252-5602.Contact Information
Primary practice address
1071 Renee Ave
Pocatello ID 83201-2508
Phone: (208) 252-5602
Fax: (208) 269-7094
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | M-10525 | Idaho |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | M-10525 | Idaho |
Profile Details
| NPI number | 1003012204 |
|---|---|
| LBN Legal business name | Clair, Charles Malcolm |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 25th, 2007 |
| Last updated | May 11th, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1003012204 | NPPES |
| Other | 11479847 | AAMC ID |
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