Healthcare Provider Details

I. General information

NPI: 1750548244
Provider Name (Legal Business Name): ALAN GREGORY MCCLURE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2008
Last Update Date: 05/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

327 HADDON AVE SUITE 1
WESTMONT NJ
08108-2831
US

IV. Provider business mailing address

327 HADDON AVE
WESTMONT NJ
08108-2831
US

V. Phone/Fax

Practice location:
  • Phone: 856-869-0009
  • Fax: 856-869-0008
Mailing address:
  • Phone: 856-869-0009
  • Fax: 856-869-0008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number25MA03972700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: