Individual
PETER JAY CLEAVINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
210 PORTLAND ST, SUITE 100, COLUMBIA, MO 65201-6677
(573) 777-8818
(573) 777-8819
Mailing address
210 PORTLAND ST, SUITE 100, COLUMBIA, MO 65201-6677
(573) 777-8818
(573) 777-8819
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
2000163862
MO
Other
Enumeration date
05/20/2006
Last updated
06/30/2010
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