Healthcare Provider Details

I. General information

NPI: 1316995459
Provider Name (Legal Business Name): SHELLEY A MCCLURE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 06/12/2023
Certification Date: 06/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 HILLTOP ST
CONNELLY SPRINGS NC
28612
US

IV. Provider business mailing address

307 WALTON RD
MORGANTON NC
28655-4215
US

V. Phone/Fax

Practice location:
  • Phone: 828-580-7432
  • Fax: 620-402-5044
Mailing address:
  • Phone: 620-218-1622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number9900602
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: