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Individual
GARY MARC MCCLERNAN
Active
Individual
GARY MARC MCCLERNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO2389
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019585300
—
FL
01
—
65368Z
INDIVIDUAL MCARE PTAN
FL
01
—
DS9118
RR MCARE IND PTAN
AL
01
—
DS9118
GROUP RR
FL
01
—
FS503A
GROUP MCARE PTAN
FL
01
—
PO2389
STATE LICENSE
FL
Enumeration date
02/02/2006
Last updated
06/16/2018
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