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Individual

CHARLES MALCOLM CLAIR JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1224 8TH ST, RUPERT, ID 83350-1599
(208) 436-0481
(208) 436-6038
Mailing address
1322 STONERIDGE DR, POCATELLO, ID 83201-5043
(208) 436-0481

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M-10525
ID
208M00000X
Hospitalist Physician
M-10525
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11479847
AAMC ID
Enumeration date
06/25/2007
Last updated
02/05/2025
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