Provider Demographics
NPI:1124389028
Name:MCCLURE, MATTHEW G (MD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:G
Last Name:MCCLURE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1865 ROUTE 70 E
Mailing Address - Street 2:SUITE 210
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-2013
Mailing Address - Country:US
Mailing Address - Phone:856-433-2641
Mailing Address - Fax:856-427-9468
Practice Address - Street 1:1865 ROUTE 70 E
Practice Address - Street 2:SUITE 210
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-2013
Practice Address - Country:US
Practice Address - Phone:856-433-2641
Practice Address - Fax:856-427-9468
Is Sole Proprietor?:No
Enumeration Date:2012-06-06
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD457475208100000X
NJ25MA09838900208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation