Individual
DR. SHAUN R MCCLENNY
Active
Individual
DR. SHAUN R MCCLENNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
03452
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
260119934
TAX ID
MD
01
—
64671401
CAREFIRST RENDERING #
MD
01
—
K7710001
CAREFIRST XIP
MD
Enumeration date
03/21/2007
Last updated
04/21/2010
Update your record
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