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NPI Code Detail

MEDICARE: MR. BRUCE E CLAY MA

MEDICARE:  MR. BRUCE E CLAY  MA
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
1103T00000XPsychologist384WV

Other Identifiers

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

General Provider Information

NPI Number : 1851479885
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BRUCE E CLAY MA
Provider Business Mailing Address
First Line : 1401 HOSPITAL DR
Second Line : STE# 106
City : HURRICANE
State : WV
Zip : 25526-9237
Country : US
Telephone Number : 304-757-8650
Fax Number : 304-757-0633
Provider Business Practice Location Address
First Line : 1401 HOSPITAL DR
Second Line : STE# 106
City : HURRICANE
State : WV
Zip : 25526-9237
Country : US
Telephone Number : 304-757-8650
Fax Number : 304-757-0633
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 07/09/2007

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Directions to “ MR. BRUCE E CLAY MA” Practice Location

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