Provider Demographics
NPI:1861466138
Name:CLEMENTE, MICHAEL A (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:A
Last Name:CLEMENTE
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:2790 CLAY EDWARDS DR
Mailing Address - Street 2:SUITE #650
Mailing Address - City:NORTH KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-3276
Mailing Address - Country:US
Mailing Address - Phone:816-459-7500
Mailing Address - Fax:816-459-9611
Practice Address - Street 1:2790 CLAY EDWARDS DR
Practice Address - Street 2:SUITE #650
Practice Address - City:NORTH KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3276
Practice Address - Country:US
Practice Address - Phone:816-559-6500
Practice Address - Fax:816-559-6553
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2010-04-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MOR9A98207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO242192722Medicaid
MO242192722Medicaid
MO0516319AMedicare PIN