MEDICARE: DR. DANNY EDWARD MCCLURE D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	DOC-049	GU
2	2084P0800X	Psychiatry Physician	007140	AZ

General Provider Information

NPI Number	:	1073855409
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANNY EDWARD MCCLURE D.O.

Provider Business Mailing Address
First Line	:	125 TUN JESUS CRISOSTOMO ST STE 104
Second Line	:
City	:	TAMUNING
State	:	GU
Zip	:	96913-3551
Country	:	US
Telephone Number	:	671-649-8638
Fax Number	:

Provider Business Practice Location Address
First Line	:	125 TUN JESUS CRISOSTOMO ST STE 104
Second Line	:
City	:	TAMUNING
State	:	GU
Zip	:	96913-3551
Country	:	US
Telephone Number	:	671-649-8638
Fax Number	:	671-648-5463

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2013
Last Update Date	:	10/23/2025

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