Individual
MARYBETH FRANCIS MCCLURE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D0
Contact information
Practice address
1411 LINCOLN WAY W, MISHAWAKA, IN 46544-1626
(574) 259-5666
Mailing address
4755 AMERITECH DR, SOUTH BEND, IN 46628-9120
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
02001001
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100354880
—
IN
Enumeration date
04/25/2006
Last updated
02/13/2014
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