Provider Demographics
NPI:1760565709
Name:MCRIPLEY, CLARENCE JR (MD)
Entity Type:Individual
Prefix:
First Name:CLARENCE
Middle Name:
Last Name:MCRIPLEY
Suffix:JR
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 1:43700 WOODWARD AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-5058
Mailing Address - Country:US
Mailing Address - Phone:248-253-9330
Mailing Address - Fax:248-253-1910
Practice Address - Street 1:43700 WOODWARD AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-5058
Practice Address - Country:US
Practice Address - Phone:248-253-9330
Practice Address - Fax:248-253-1910
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MICM029141207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine