DR. CLINZO P. MICKLE II (NPI# 1104096361) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104096361 |
| Entity Type | Individual |
| Full Name | DR. CLINZO P. MICKLE II |
| Credential | M.D. |
| Practice Address |
650 Pennsylvania Ave Se Suite 420 Washington DC 20003-4318 |
| Mailing Address |
2400 16th St Nw Apt. 243 Washington DC 20009-6646 |
| Practice Telephone | 2025479001 |
| Mailing Telephone | 2023322802 |
| Enumeration Date | 2008-03-04 |
| Last Update Date | 2011-04-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | MD036757 | DC | Allopathic & Osteopathic Physicians |
| Street Address |
650 PENNSYLVANIA AVE SE SUITE 420 |
| City | WASHINGTON |
| State | DC |
| Zip Code | 20003-4318 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275594970 | Salim I Butrus | Ophthalmology | 650 Pennsylvania Ave Se, Suite 270, Washington, DC 20003-4318 | 2006-03-31 |
| 1942869920 | Chloe Ambrose | Social Worker | 650 Pennsylvania Ave Se, Washington, DC 20003-4318 | 2019-06-12 |
| 1871152033 | Lauren Fadem | Counselor | 650 Pennsylvania Ave Se, Washington, DC 20003-4318 | 2019-06-11 |
| 1336708593 | Lamar Smith | Social Worker | 650 Pennsylvania Ave Se, Washington, DC 20003-4318 | 2019-06-11 |
| 1417459835 | Kathleen Gem Shaw | Clinical Neuropsychologist | 650 Pennsylvania Ave Se, Washington, DC 20003-4318 | 2018-03-01 |
| 1336691450 | Capitol Hill Pediatric Dentistry | Dentist | 650 Pennsylvania Ave Se, 220, Washington, DC 20003-4318 | 2016-10-25 |
| 1114308384 | Paradigm Integrative Health, LLC | Psychiatry & Neurology | 650 Pennsylvania Ave Se, Suite 470, Washington, DC 20003-4318 | 2015-06-14 |
| 1013330570 | Sarah Marie Creveling | Counselor | 650 Pennsylvania Ave Se, Lr, Washington, DC 20003-4318 | 2014-02-03 |
| 1144560509 | Irene Mendoza | Counselor | 650 Pennsylvania Ave Se, Suite 240, Washington, DC 20003-4318 | 2013-02-22 |
| 1609141548 | Tsega Gsilassie | Physician Assistant | 650 Pennsylvania Ave Se, Ste 220, Washington, DC 20003-4318 | 2012-03-10 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720686694 | Joy Mpode Nkede | Home Health Aide | 2012 12th Street Se, G35, Washington, DC 20003 | 2020-10-13 |
| 1548872617 | Marie Lubin | Licensed Practical Nurse | 100 New Jersery Ave Se, Suite 845, Washington, DC 20003 | 2020-08-20 |
| 1770115081 | District of Columbia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 15 I Street Se, Washington, DC 20003 | 2020-02-05 |
| 1538706676 | Eric Schwartz | Specialist/Technologist | 2400 E Capitol St Se, Washington, DC 20003 | 2019-12-09 |
| 1669945879 | Taiwo O Adeyemo | Nurse Practitioner | Unity Health Care, Inc Department of Corrections, 1901 D Street Se, Washington, DC 20003 | 2019-01-10 |
| 1881164424 | Heather Yvonne Daniels | Social Worker | 650 I Street Ne, Washington, DC 20003 | 2018-11-27 |
| 1467946566 | Fanta Boakai Sheriff | Home Health Aide | 1202 12th Street Se, Washington, DC 20003 | 2018-06-21 |
| 1881117513 | Rose Physcial Therapy Group | Physical Therapist | 1015 Half Street #102, Washington, DC 20003 | 2017-07-25 |
| 1821510280 | Tiara Doniece Jackson | Technician | 601 L St Se, Apt 1001, Washington, DC 20003 | 2017-07-07 |
| 1083134985 | Sophia Olivia Hooper | Home Health Aide | 1612 A St Se, Washington, DC 20003 | 2017-06-21 |
| Find all providers in zip 20003 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699305540 | Epiarx | Dermatology | 4712 Windom Pl Nw, Washington, DC 20016-2406 | 2020-01-20 |
| 1922460906 | Caroline Michaux Lewis Stovall | Dermatology | 2153 California St Nw Apt 602, Washington, DC 20008-1852 | 2016-03-28 |
| 1871950105 | Integrated Dermatology of I Street, LLC | Dermatology | 1712 I St Nw Ste 712, Washington, DC 20006-3747 | 2016-01-18 |
| 1538554951 | Stephen Suah | Dermatology | 4910 Massachusetts Ave Nw Ste 308, Washington, DC 20016-4382 | 2015-04-02 |
| 1194163063 | Casey Marie Chern | Dermatology | 400 8th St Nw Apt 1301, Washington, DC 20004-2126 | 2013-06-12 |
| 1013351436 | Lauren Mckelroy | Dermatology | 2141 K St Nw Ste 307, Washington, DC 20037-1873 | 2013-04-29 |
| 1336583426 | Huonggiang Nguyen | Dermatology | 1520 16th St Nw Apt 302, Washington, DC 20036-1440 | 2013-04-19 |
| 1457694010 | Thomas Leeney Adrian | Dermatology | 3301 New Mexico Ave Nw Ste 240, Washington, DC 20016-3610 | 2013-04-02 |
| 1801166467 | Integrated Dermatology of 19th Street LLC | Dermatology | 1145 19th St Nw Ste 301, Washington, DC 20036-3718 | 2012-01-12 |
| 1255668356 | Ecu Physicians Washington Office | Dermatology | 1240 Cowell Farm Rd, Washington, NC 27889-3440 | 2009-11-10 |
| Find all providers in WASHINGTON | ||||
| City | WASHINGTON |
| Zip Code | 20003 |
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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.