Individual
TODD MATTHEW MCCLEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1 SAINT ELIZABETH BLVD STE 104, O FALLON, IL 62269-1099
(618) 234-2120
Mailing address
1 SAINT ELIZABETH BLVD STE 104, O FALLON, IL 62269-1099
(618) 234-2120
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
132185
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
209002590
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
915864417
—
MO
Enumeration date
01/10/2006
Last updated
01/06/2022
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