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General NPI Number Information
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NPI Number | 1073680708
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Entity Type | Individual
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Provider Name | WALTER L MCLEAN MD
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Gender | Male
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 12/11/2012
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Provider Practice Location Address
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Address Line | 4 OLD DOCK ROAD
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City | WEST FALMOUTH
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State | MA
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Zip | 02540
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Country | US
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Telephone | 508-548-1812
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 843
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City | WEST FALMOUTH
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State | MA
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Zip | 02574-0843
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Country | US
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Telephone | 508-548-1812
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | 26791
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License Number State | MA
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