Provider Demographics
NPI:1003903600
Name:CLARY, STEPHEN JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:JOSEPH
Last Name:CLARY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:7550 LUCERNE DR
Mailing Address - Street 2:SUITE 405
Mailing Address - City:MIDDLEBURG HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-6503
Mailing Address - Country:US
Mailing Address - Phone:440-234-8833
Mailing Address - Fax:440-234-3313
Practice Address - Street 1:6087 RIDGE RD
Practice Address - Street 2:SUITE 2
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-4472
Practice Address - Country:US
Practice Address - Phone:440-884-7272
Practice Address - Fax:440-884-7972
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2014-04-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35-05-0093 C207R00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0552352Medicaid
OH000000133316OtherANTHEM
OH0552352Medicaid
OH9265371Medicare ID - Type Unspecified
OHA15831Medicare UPIN