Mr Clifford C Souder, PHYSICIAN ASSISTANT in Bolling Afb, DC - Medicare Physician Assistant

Mr Clifford C Souder, PHYSICIAN ASSISTANT is a medicare enrolled "Physician Assistant" in Bolling Afb, District Of Columbia. His current practice location is 238 Brookley Ave Sw, Bolling Afb, District Of Columbia. You can reach out to his office (for appointments etc.) via phone at (202) 404-6491.

Mr Clifford C Souder is licensed to practice in Virginia (license number 0110003746) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1679751200.

Contact Information

	Mr Clifford C Souder, PHYSICIAN ASSISTANT
	238 Brookley Ave Sw, Bolling Afb, DC 20032-7704
	(202) 404-6491
	Not Available

Provider's Profile

Full Name	Mr Clifford C Souder
Gender	Male
Speciality	Physician Assistant
Location	238 Brookley Ave Sw, Bolling Afb, District Of Columbia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1679751200
Provider Enumeration Date: 02/06/2008
Last Update Date: 10/20/2023

Medicare PECOS Information:

PECOS PAC ID: 8325275670
Enrollment ID: I20131212001555

Medical Identifiers

Medical identifiers for Mr Clifford C Souder such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1679751200	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363A00000X	Physician Assistant	0110003746 (Virginia)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Clifford C Souder is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Clifford C Souder, PHYSICIAN ASSISTANT 238 Brookley Ave Sw, Bolling Afb, DC 20032-7704 Ph: (202) 404-6491	Mr Clifford C Souder, PHYSICIAN ASSISTANT 238 Brookley Ave Sw, Bolling Afb, DC 20032-7704 Ph: (202) 404-6491

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Physician Assistant Nurses in Bolling Afb, DC

Lauren S. Hicks, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 238 Brookley Ave, Bolling Afb, DC 20332 Phone: 202-767-5536
John Lloyd Chitwood, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 238 Brookley Avenue, Bolling Afb, DC 20332 Phone: 202-404-3603
Kurtis Lee Dean, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 238 Brookley Ave, Bolling Afb, DC 20332 Phone: 202-404-3603
Taylor Bottari, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 238 Brookley Ave Sw Bldg 1300, Bolling Afb, DC 20032 Phone: 202-404-2544 Fax: 202-404-3197
Amanda Nicole Collins, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 238 Brookley Avenue, Bolling Afb, DC 22032 Phone: 202-404-7932
Raquel Tanzswa Hall, PHYSICIAN ASSISTANT Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 238 Brookley Ave Sw Bldg 1300, Bolling Afb, DC 20032 Phone: 202-404-3906

Mr Clifford C Souder, PHYSICIAN ASSISTANT - Medicare Physician Assistant in Bolling Afb, DC