Provider Demographics
NPI:1194342162
Name:BICYCLE HEALTH MEDICAL GROUP PA
Entity type:Organization
Organization Name:BICYCLE HEALTH MEDICAL GROUP PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:CLEAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-928-7800
Mailing Address - Street 1:P.O. BOX 32750
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915
Mailing Address - Country:US
Mailing Address - Phone:844-943-2514
Mailing Address - Fax:
Practice Address - Street 1:506 SECOND AVENUE
Practice Address - Street 2:SUITE 1400, OFFICE 1515
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104
Practice Address - Country:US
Practice Address - Phone:844-943-2514
Practice Address - Fax:628-777-2580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-25
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Multi-Specialty