Provider Demographics
NPI:1851464028
Name:MCCLURE, DAVID C (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:C
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 1:1255 PINEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-2713
Mailing Address - Country:US
Mailing Address - Phone:304-598-3301
Mailing Address - Fax:304-599-7346
Practice Address - Street 1:1255 PINEVIEW DR
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-2713
Practice Address - Country:US
Practice Address - Phone:304-598-3301
Practice Address - Fax:304-599-7346
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV10170207W00000X
VA0101264731207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA158568101Medicaid
WV0096712000Medicaid
MD812620800Medicaid
WV0483775Medicare ID - Type Unspecified
WV0693170002Medicare NSC
WV0483774Medicare ID - Type Unspecified
MD055L468RMedicare ID - Type Unspecified
MD812620800Medicaid
B42584Medicare UPIN
PA158568101Medicaid