Healthcare Provider Details

I. General information

NPI: 1649845363
Provider Name (Legal Business Name): CHARLEE KADEEN MCLEAN-POWELL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHARLEE KADEEN MCLEAN

II. Dates (important events)

Enumeration Date: 05/25/2021
Last Update Date: 06/05/2025
Certification Date: 06/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 N BROAD ST
PHILADELPHIA PA
19140-5103
US

IV. Provider business mailing address

6201 GREENLEIGH AVE
MIDDLE RIVER MD
21220-2004
US

V. Phone/Fax

Practice location:
  • Phone: 215-707-9900
  • Fax:
Mailing address:
  • Phone: 410-933-6423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD0100782
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207RI0008X
TaxonomyHepatology Physician
License NumberMD489228
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: