Provider Demographics
NPI:1942555081
Name:PENDLETON, CLAY MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:CLAY
Middle Name:MICHAEL
Last Name:PENDLETON
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 1:501 ANGLERS DR STE 202
Mailing Address - Street 2:
Mailing Address - City:STEAMBOAT SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80487-8841
Mailing Address - Country:US
Mailing Address - Phone:970-871-9710
Mailing Address - Fax:
Practice Address - Street 1:501 ANGLERS DR
Practice Address - Street 2:SUITE 202
Practice Address - City:STEAMBOAT SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80487-8840
Practice Address - Country:US
Practice Address - Phone:970-871-9710
Practice Address - Fax:970-871-9709
Is Sole Proprietor?:No
Enumeration Date:2012-07-15
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0053605174400000X, 208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO50038044Medicaid
CO50038044Medicaid