Provider Demographics
NPI:1609215003
Name:MCQUEARY, ERIC W (DO)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:W
Last Name:MCQUEARY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:27351 DEQUINDRE RD
Mailing Address - Street 2:
Mailing Address - City:MADISON HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48071-3487
Mailing Address - Country:US
Mailing Address - Phone:248-967-7795
Mailing Address - Fax:248-967-7794
Practice Address - Street 1:1029 NICHOLS RD STE 401
Practice Address - Street 2:
Practice Address - City:OSAGE BEACH
Practice Address - State:MO
Practice Address - Zip Code:65065
Practice Address - Country:US
Practice Address - Phone:573-302-3111
Practice Address - Fax:573-302-2869
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-19
Last Update Date:2018-06-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101020727208800000X
MO2018011432208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology