Healthcare Provider Details

I. General information

NPI: 1629173976
Provider Name (Legal Business Name): KIA MAUREEN MCLEAN WASHINGTON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 09/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12605 E 16TH AVE
AURORA CO
80045-2545
US

IV. Provider business mailing address

PO BOX 110429
AURORA CO
80042-0429
US

V. Phone/Fax

Practice location:
  • Phone: 720-848-0000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberMD429364
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberMD429364
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code2082S0105X
TaxonomySurgery of the Hand (Plastic Surgery) Physician
License NumberMD429364
License Number StatePA
# 4
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License NumberDR.0060517
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: