MEDICARE: CARLA B MACLEOD MD & ASSOCIATES PC

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	291U00000X	Clinical Medical Laboratory	21D0947364	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	220025431	OTHER		RAILROAD
2	4504	OTHER	DC	BCBS OF WASHINGTON DC
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760481568
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARLA B MACLEOD MD & ASSOCIATES PC

Provider Business Mailing Address
First Line	:	PO BOX 630984
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21263-0984
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	18207A FLOWER HILL WAY
Second Line	:
City	:	GAITHERSBURG
State	:	MD
Zip	:	20879-5331
Country	:	US
Telephone Number	:	301-926-4707
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CARLA BELTRAN MACLEOD
Credential	:	MD
Telephone Number	:	304-926-4707

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	02/17/2010

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