1457411134 NPI number — JOHN R MCLEAN MD & ASSOCIATES PA

Table of content: (NPI 1457411134)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457411134 NPI number — JOHN R MCLEAN MD & ASSOCIATES PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JOHN R MCLEAN MD & ASSOCIATES PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
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:
1457411134
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1315 S DIVISION STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SALISBURY
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21804-6920
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-677-4949
Provider Business Mailing Address Fax Number:
401-749-4988

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1315 S DIVISION STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SALISBURY
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21804-6920
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-677-4949
Provider Business Practice Location Address Fax Number:
401-749-4988
Provider Enumeration Date:
12/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MCLEAN
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
R
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
410-677-4949

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0000203901 . This is a "MADE INDIVIDUAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 253AJO . This is a "BSMD GROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: J333 . This is a "BSDC GROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0001 . This is a "BSDC INDIVIDUAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 42418203 . This is a "BSMD INDIVIDUAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4405389 . This is a "AET" identifier . This identifiers is of the category "OTHER".
  • Identifier: 770M335F . This is a "MBMD INDIVIDUAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8432071 . This is a "CIG" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1000033474 . This is a "DHMO INDIVIDUAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2500303 . This is a "UHCM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 770M . This is a "MBMD GROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: DA8686 . This is a "MBRR GROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 57465 . This is a "COV" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1000025859 . This is a "MADE GROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: P00075521 . This is a "MBRR INDIVIDUAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 30128 . This is a "MAMS" identifier . This identifiers is of the category "OTHER".




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