Provider Demographics
NPI:1306985494
Name:VAN CLEEFF, MARTIN (MD)
Entity type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:
Last Name:VAN CLEEFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 CRESCENTCOMMONS DR STE 250
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-8134
Mailing Address - Country:US
Mailing Address - Phone:919-859-9866
Mailing Address - Fax:919-859-9957
Practice Address - Street 1:115 CRESCENTCOMMONS DR STE 250
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-8134
Practice Address - Country:US
Practice Address - Phone:919-859-9866
Practice Address - Fax:919-859-9957
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9500470207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8984729Medicaid
NC84729OtherBCBS
63261OtherMEDCOST
110167671OtherRAILROAD MEDICARE
0452676OtherUNITED HEALTHCARE
4284772OtherCIGNA
NC84729OtherBCBS
NC8984729Medicaid
NC2209524GMedicare PIN