Individual
HENRY W CLEVER III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
901 S 5TH ST, ST CHARLES, MO 63301
(636) 916-1300
(636) 916-1561
Mailing address
901 S 5TH ST, ST CHARLES, MO 63301
(636) 916-1300
(636) 916-1561
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
R4P68
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203348628
—
MO
Enumeration date
05/02/2006
Last updated
02/20/2017
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