Warren, Clinton Charles

Warren, Clinton Charles is an individual health care provider with primary practice located at 5017 Green Bay Rd Ste 148 , Kenosha WI 53144-1782. He recently has only one registered license in Allopathic & Osteopathic Physicians / Retina Specialist, which is considered as his primary health care specialty. Warren, Clinton Charles can be contacted via phone (262) 420-5888.

Contact Information

Primary practice address
5017 Green Bay Rd Ste 148 Kenosha WI 53144-1782
Phone: (262) 420-5888
Fax: (262) 420-5888
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Retina Specialist 207WX0107X 61666-20 Wisconsin

Profile Details

NPI number 1902162076
LBN Legal business name Warren, Clinton Charles
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 3rd, 2012
Last updated Aug 10th, 2022 - about 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902162076 NPPES
Wisconsin MEDICAID 1902162076

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