Basic Information
| Provider Information | |||||||||
| NPI: | 1801866991 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CLEMANS | ||||||||
| FirstName: | CECILIA | ||||||||
| MiddleName: | L. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5 WASHINGTON PL | ||||||||
| Address2: | DARTMOUTH HITCHCOCK - OB/GYN | ||||||||
| City: | BEDFORD | ||||||||
| State: | NH | ||||||||
| PostalCode: | 031106736 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6036952900 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5 WASHINGTON PL | ||||||||
| Address2: | DARTMOUTH HITCHCOCK - OB/GYN | ||||||||
| City: | BEDFORD | ||||||||
| State: | NH | ||||||||
| PostalCode: | 031106736 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6036952900 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/23/2006 | ||||||||
| LastUpdateDate: | 01/08/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VG0400X | 10044 | NH | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 30010686 | 05 | NH | MEDICAID |