Provider Demographics
NPI:1023675501
Name:MCCLARD, CYNTHIA K (MD PHD)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:K
Last Name:MCCLARD
Suffix:
Gender:F
Credentials:MD PHD
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:J
Other - Last Name:KIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3601 W 76TH ST STE 300
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-3004
Mailing Address - Country:US
Mailing Address - Phone:952-929-1131
Mailing Address - Fax:
Practice Address - Street 1:3601 W 76TH ST STE 300
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-3004
Practice Address - Country:US
Practice Address - Phone:952-929-1131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-21
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN79236207WX0107X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist