Provider Demographics
NPI:1386640514
Name:MCCLUER, BRYAN ANDREW (MD)
Entity Type:Individual
Prefix:MR
First Name:BRYAN
Middle Name:ANDREW
Last Name:MCCLUER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1501 TATE BLVD SE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-4243
Mailing Address - Country:US
Mailing Address - Phone:828-485-2707
Mailing Address - Fax:828-485-2708
Practice Address - Street 1:1501 TATE BLVD SE
Practice Address - Street 2:SUITE 202
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-4243
Practice Address - Country:US
Practice Address - Phone:828-485-2707
Practice Address - Fax:828-485-2708
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200400914208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891364MMedicaid
NCD6777OtherMEDCOST
NC1364MOtherBCBS NC
NC9330283OtherCIGNA
NC9330283OtherCIGNA
NCD6777OtherMEDCOST