Individual
MICHAEL J CLEARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
226 S WOODS MILL RD, SUITE 52 WEST, CHESTERFIELD, MO 63017-3662
(314) 434-2399
(314) 434-5653
Mailing address
9336 PINE AVE, BRENTWOOD, MO 63144-1008
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
2004023908
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1124098546
—
MO
01
—
196234
BC/BS MISSOURI
MO
05
—
207190802
—
MO
01
—
P01032450
RAILROAD MEDICARE
MO
Enumeration date
01/26/2006
Last updated
08/25/2014
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