Individual
MR. CLARE DE PUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1414 W FAIR AVE, STE 134, MARQUETTE, MI 49855-2675
(906) 226-2233
(906) 226-2409
Mailing address
1414 W FAIR AVE, SUITE 134, MARQUETTE, MI 49855-2675
(906) 226-2233
(906) 226-2409
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601001211
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5601001211
MI STATE MEDICAL LICENSE
MI
Enumeration date
08/30/2006
Last updated
03/07/2023
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