1114053493 NPI number — DR. IAN DONALD MACLEOD MD

Table of content: DR. IAN DONALD MACLEOD MD (NPI 1114053493)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114053493 NPI number — DR. IAN DONALD MACLEOD MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MACLEOD
Provider First Name:
IAN
Provider Middle Name:
DONALD
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114053493
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
BOX 10001
Provider Second Line Business Mailing Address:
PMB 3739
Provider Business Mailing Address City Name:
SALPAN
Provider Business Mailing Address State Name:
MP
Provider Business Mailing Address Postal Code:
96950-8901
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
670-234-8950
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 LOWER NAVY HILL
Provider Second Line Business Practice Location Address:
COMMONWEALTH HEALTH CENTER LOWER NAVY MILL
Provider Business Practice Location Address City Name:
SAIPAN
Provider Business Practice Location Address State Name:
MP
Provider Business Practice Location Address Postal Code:
96950
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
670-234-8950
Provider Business Practice Location Address Fax Number:
670-236-8608
Provider Enumeration Date:
02/23/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X , with the licence number:  0111 , registered in the state of MP ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)