Provider Demographics
NPI:1003135997
Name:MCCLURE, ERIN LOUISE (PA-C)
Entity Type:Individual
Prefix:MS
First Name:ERIN
Middle Name:LOUISE
Last Name:MCCLURE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 THOMAS JOHNSON DR STE H
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4895
Mailing Address - Country:US
Mailing Address - Phone:240-453-0050
Mailing Address - Fax:240-453-0053
Practice Address - Street 1:75 THOMAS JOHNSON DR STE H
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4895
Practice Address - Country:US
Practice Address - Phone:240-453-0050
Practice Address - Fax:240-453-0053
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-18
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0006450363A00000X
FLPA9106052363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant