Martin Cleary, MD
Individual provider Active NPI Family Medicine Physician · Darlington, WI
NPI 1104890482 · NPPES record last updated Nov 16, 2018
Key facts
- NPI
- 1104890482
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 64855-20 (WI)
- Practice address
- 731 Clay St
Darlington, WI 53530 - Phone
- (608) 776-4497
- NPI assigned
- Feb 14, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-066997 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Health of Lafayette County | Family Medicine | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036-066997 | IL | |
| Family Medicine Physician | 207Q00000X | 64855-20 | WI | Yes |
Addresses
Primary practice location
731 Clay St
Darlington, WI 53530
Mailing address
731 Clay St
Darlington, WI 53530-1225
Phone (608) 776-4497
Other practice location 1
606 Tisdell Ave
Warren, IL 61087-9741
Phone (815) 756-2644
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 32660300 | Medicaid | WI | |
| 036066997 | Medicaid | IL |
Other providers in Darlington, WI
- Robert James Bernardoni
- Debasish Bhattacharyya
- Kathryn E Bliss
- McKenzie Burkholder
- Heidi A Byrnes
- Community Health Systems, Inc.
- Tara Cook
- Laura Coulthard
- Darlington Community School District
- Davis Bus Lines
All providers in Darlington, WI · Family Medicine Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 16, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.