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Individual

DAVID WESLEY CLEAVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
1316 COUNTRY CLUB DR, KIRKSVILLE, MO 63501-5362
(660) 627-7546
(660) 956-7097
Mailing address
1316 COUNTRY CLUB DR, KIRKSVILLE, MO 63501-5362
(660) 627-7546
(660) 956-7097

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
2010022125
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000014853
MEDICARE GROUP
01
2010022125
LICENSE
MO
01
501218200
MEDICAID GROUP
Enumeration date
06/29/2007
Last updated
07/08/2013
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