Mcclew, Todd Matthew

Mcclew, Todd Matthew is an individual health care provider with primary practice located at 1 Saint Elizabeth Blvd Ste 104 , O Fallon IL 62269-1099. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Mcclew, Todd Matthew can be contacted via phone (618) 234-2120.

Contact Information

Primary practice address
1 Saint Elizabeth Blvd Ste 104 O Fallon IL 62269-1099
Phone: (618) 234-2120
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 132185 Missouri
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 209002590 Illinois

Profile Details

NPI number 1790764686
LBN Legal business name Mcclew, Todd Matthew
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 10th, 2006
Last updated Jan 6th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790764686 NPPES
Missouri MEDICAID 915864417

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