MEDICARE: DR. ANGELINE MCLEAN OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152WC0802X	Corneal and Contact Management Optometrist	18003121B	IN

General Provider Information

NPI Number	:	1225165905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANGELINE MCLEAN OD

Provider Business Mailing Address
First Line	:	14250 CLAY TERRACE BLVD STE 160
Second Line	:
City	:	CARMEL
State	:	IN
Zip	:	46032-3633
Country	:	US
Telephone Number	:	317-844-2020
Fax Number	:

Provider Business Practice Location Address
First Line	:	14250 CLAY TERRACE BLVD STE 160
Second Line	:
City	:	CARMEL
State	:	IN
Zip	:	46032-3633
Country	:	US
Telephone Number	:	317-844-2020
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/28/2007
Last Update Date	:	08/08/2024

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