Healthcare Provider Details

I. General information

NPI: 1346336716
Provider Name (Legal Business Name): TERRY E MCLEAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7425 E SHEA BLVD SUITE 114
SCOTTSDALE AZ
85260-6411
US

IV. Provider business mailing address

7425 E SHEA BLVD SUITE 114
SCOTTSDALE AZ
85260-6411
US

V. Phone/Fax

Practice location:
  • Phone: 480-315-0900
  • Fax: 480-315-1300
Mailing address:
  • Phone: 480-315-0900
  • Fax: 480-315-1300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number18855
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: