Provider Demographics
NPI:1356342570
Name:TRUEBLOOD, MICHAEL CLARKE (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:CLARKE
Last Name:TRUEBLOOD
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 1:9 BIENVILLE AVE
Mailing Address - Street 2:ORTHOPAEDIC ASSOCIATES OF SOUTHEAST MISSOURI PC
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63701-1944
Mailing Address - Country:US
Mailing Address - Phone:573-335-8257
Mailing Address - Fax:573-335-8424
Practice Address - Street 1:48 DOCTORS PARK
Practice Address - Street 2:ORTHOPAEDIC ASSOCIATES OF SOUTHEAST MISSOURI PC
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63703-4928
Practice Address - Country:US
Practice Address - Phone:573-335-8257
Practice Address - Fax:573-335-8424
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR8424207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
A27016Medicare UPIN
MO000009476Medicare PIN