Provider Demographics
NPI:1770594038
Name:MCCLANE, STEVEN J (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:J
Last Name:MCCLANE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:70 MILL RIVER ST
Mailing Address - Street 2:SUITE LL1
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902
Mailing Address - Country:US
Mailing Address - Phone:203-323-8989
Mailing Address - Fax:203-975-9904
Practice Address - Street 1:70 MILL RIVER ST
Practice Address - Street 2:SUITE LL1
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902
Practice Address - Country:US
Practice Address - Phone:203-323-8989
Practice Address - Fax:203-975-9904
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT038508208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
2398955002OtherCIGNA
010038508CT01OtherANTHEM
703741OtherCONNECTICARE
280001075OtherMEDICARE RAILROAD
280001075OtherMEDICARE RAILROAD
280000024Medicare ID - Type Unspecified