Healthcare Provider Details

I. General information

NPI: 1669114765
Provider Name (Legal Business Name): DAVID MICHAEL MCLEAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2022
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1734 STATE ROUTE 31 STE 202
CLINTON NJ
08809-2059
US

IV. Provider business mailing address

1736 HAMILTON ST
ALLENTOWN PA
18104-5656
US

V. Phone/Fax

Practice location:
  • Phone: 484-822-5221
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number25MD00394200
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberSC007289
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: