Provider Demographics
NPI:1235125808
Name:MCCLOY, STEVEN GEORGE (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:GEORGE
Last Name:MCCLOY
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:100 SMITHFIELD AVE
Mailing Address - Street 2:AXIOM OCCUPATIONAL HEALTH LLC
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-3497
Mailing Address - Country:US
Mailing Address - Phone:401-312-0545
Mailing Address - Fax:401-312-0954
Practice Address - Street 1:100 SMITHFIELD AVE
Practice Address - Street 2:AXIOM OCCUPATIONAL HEALTH LLC
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-3474
Practice Address - Country:US
Practice Address - Phone:401-312-0545
Practice Address - Fax:401-725-8064
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-20
Last Update Date:2010-03-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RI05160207R00000X, 2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA50318OtherSTATE LICENSE
RIRI05160OtherSTATE LICENSE
RIW87226Medicare UPIN