| Doctor Name: | DR. RAYMOND JOSEPH CLYDESDALE |
| NPI Number: | 1699764340 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | OS012364 |
| Business Practice Address: | 31st Medical Group/sgpf - Aviano Unit 6180 Box 245 Apo, AE - 09604-245 |
| Business Phone Number: | 011390434305101 |
| Business Fax Number: | |
| Mailing Address: | Psc 54, Box 2561 APO |
| State: | AE |
| Postal Code: | 09601 |
| Phone Number: | 01139043471952 |
| Fax Number: | |
| NPI Enumeration Date: | 10/17/2005 |
| NPI Last Update Date: | 04/20/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | OS012364 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |