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NPI Code Detail

MEDICARE: MARY MICHAL MCCLURE MSW

MEDICARE: MARY MICHAL MCCLURE MSW
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
1104100000XSocial Worker02528IA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1700043445
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY MICHAL MCCLURE MSW
Provider Business Mailing Address
First Line : 2213 GRAND AVE
Second Line :
City : DES MOINES
State : IA
Zip : 50312-5305
Country : US
Telephone Number : 515-237-3974
Fax Number : 515-883-2692
Provider Business Practice Location Address
First Line : 600 42ND ST
Second Line :
City : DES MOINES
State : IA
Zip : 50312-2701
Country : US
Telephone Number : 515-255-8399
Fax Number : 515-255-8405
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2008
Last Update Date : 04/05/2010

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Directions to “ MARY MICHAL MCCLURE MSW” Practice Location

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