Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 35-05-0093 C | OH |
N | 111NI0900X | Internist | 35-05-0093 C | OH |
Y | 207RP1001X | Pulmonary Disease | 35-05-0093 C | OH |
NPI | 1003903600 |
---|---|
Provider Name | Dr. Stephen Joseph Clary |
First Address | Middleburg Hts, OH 44130-6503 |
Second Address | Parma, OH 44129-4472 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2006 |
Last Update Date | 16/04/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000133316 | ANTHEM (01) | OH |
0552352 | (05) | OH |
A15831 | (02) | OH |