Provider Demographics
NPI:1649150186
Name:CLEVENGER, DANIEL RYAN (PA-C)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:RYAN
Last Name:CLEVENGER
Suffix:
Gender:M
Credentials:PA-C
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9307 UPTON RD
Mailing Address - Street 2:
Mailing Address - City:LAINGSBURG
Mailing Address - State:MI
Mailing Address - Zip Code:48848-9356
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1200 S FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48859-2001
Practice Address - Country:US
Practice Address - Phone:989-774-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-04
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant