Healthcare Provider Details

I. General information

NPI: 1659664761
Provider Name (Legal Business Name): MCLEOD BUSINESS GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2011
Last Update Date: 05/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 K ST NW SUITE 350
WASHINGTON DC
20005-3500
US

IV. Provider business mailing address

1425 K ST NW SUITE 350
WASHINGTON DC
20005-3500
US

V. Phone/Fax

Practice location:
  • Phone: 202-669-3023
  • Fax:
Mailing address:
  • Phone: 202-669-3023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State

VIII. Authorized Official

Name: MR. BOBBY THOMAS MCLEOD
Title or Position: PRESIDENT CEO
Credential:
Phone: 202-669-3023