Individual
THOMAS LEO CLEARY III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
618 HOSPITAL RD, TAPPAHANNOCK, VA 22560-5000
(804) 443-6297
(804) 443-6150
Mailing address
856 J CLYDE MORRIS BLVD, SUITE A, NEWPORT NEWS, VA 23601-1318
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101241758
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12102701
CAQH
VA
05
—
1275739070
—
VA
Enumeration date
06/27/2007
Last updated
07/21/2014
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