Provider Demographics
NPI:1922742378
Name:MCCLURG, CAMDEN JAMES
Entity Type:Individual
Prefix:
First Name:CAMDEN
Middle Name:JAMES
Last Name:MCCLURG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9920 JUNIPER CT
Mailing Address - Street 2:
Mailing Address - City:CONCORD TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:44060-7225
Mailing Address - Country:US
Mailing Address - Phone:440-477-1760
Mailing Address - Fax:
Practice Address - Street 1:9920 JUNIPER CT
Practice Address - Street 2:
Practice Address - City:CONCORD TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:44060-7225
Practice Address - Country:US
Practice Address - Phone:440-477-1760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-22
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
376J00000X, 3747P1801X, 172A00000X, 347C00000X
OHHGF5160172A00000X, 347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No376J00000XNursing Service Related ProvidersHomemaker
No172A00000XOther Service ProvidersDriver
No347C00000XTransportation ServicesPrivate Vehicle