Individual
MICHAEL J CLEARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
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
Update your record
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