Healthcare Provider Details

I. General information

NPI: 1811975915
Provider Name (Legal Business Name): MICHAEL E MCCLEERY P.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2006
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

799 E HAMPDEN AVE STE 305
ENGLEWOOD CO
80113-2766
US

IV. Provider business mailing address

9195 GRANT ST STE 205
THORNTON CO
80229-4386
US

V. Phone/Fax

Practice location:
  • Phone: 720-307-7246
  • Fax: 720-502-5271
Mailing address:
  • Phone: 720-307-7246
  • Fax: 720-502-5271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1678
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number1678
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: