Provider Demographics
NPI:1902011331
Name:SAVAGE, CLARE MICHELLE (MD)
Entity Type:Individual
Prefix:
First Name:CLARE
Middle Name:MICHELLE
Last Name:SAVAGE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CLARE
Other - Middle Name:
Other - Last Name:MCCAFFREY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3508 SOUTHWESTERN BLVD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-7454
Mailing Address - Country:US
Mailing Address - Phone:214-616-4502
Mailing Address - Fax:214-504-6156
Practice Address - Street 1:1119 W CHERRY AVE
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73703-3320
Practice Address - Country:US
Practice Address - Phone:214-504-6156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2019-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM54862085R0202X
OK331902085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX185687402Medicaid
TX185687401Medicaid
TX8J5948Medicare PIN
TX185687402Medicaid
TX8J5947Medicare PIN