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Individual
KEVIN P MCCLURG
Active
Individual
KEVIN P MCCLURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A. - C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10002821
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3976MC
REGENCE BLUESHIELD
WA
01
—
423898000
GROUP HEALTH COOPERATIVE
WA
05
—
8335010
—
WA
Enumeration date
04/25/2006
Last updated
12/15/2010
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