Provider Demographics
NPI:1811150238
Name:MCCLEARY, KATHERINE D (MD)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:D
Last Name:MCCLEARY
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:455 TOLL GATE RD
Mailing Address - Street 2:PRC AND CREDENTIALING
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-2759
Mailing Address - Country:US
Mailing Address - Phone:401-273-0641
Mailing Address - Fax:401-273-2919
Practice Address - Street 1:640 GEORGE WASHINGTON HIGHWAY
Practice Address - Street 2:BUILDING A, SUITE 102
Practice Address - City:LINCOLN
Practice Address - State:RI
Practice Address - Zip Code:02865
Practice Address - Country:US
Practice Address - Phone:401-921-7900
Practice Address - Fax:401-921-6959
Is Sole Proprietor?:No
Enumeration Date:2008-07-07
Last Update Date:2022-12-05
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Provider Licenses
StateLicense IDTaxonomies
MA253399207Q00000X
RIMD13737207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine