Healthcare Provider Details

I. General information

NPI: 1780177519
Provider Name (Legal Business Name): CHRISTIANA MICHELLE DORSEY MCLEAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2018
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1327 ROBESON ST
FAYETTEVILLE NC
28305-5531
US

IV. Provider business mailing address

1327 ROBESON ST
FAYETTEVILLE NC
28305-5531
US

V. Phone/Fax

Practice location:
  • Phone: 910-486-5437
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number010031
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: