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General NPI Number Information
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NPI Number | 1285908137
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Entity Type | Organization
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Legal Business Name | CARMEN FOSTER MCLEAN, M.D. PLLC
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Dates
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Enumeration Date | 02/23/2012
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Last Update Date | 02/23/2012
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Provider Practice Location Address
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Address Line | 4400 FALLS OF NEUSE RD SUITE 100
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City | RALEIGH
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State | NC
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Zip | 27609-6269
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Country | US
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Telephone | 919-876-8140
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Fax |
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Provider Business Mailing Address
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Address Line | 4400 FALLS OF NEUSE RD SUITE 100
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City | RALEIGH
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State | NC
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Zip | 27609-6269
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Country | US
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Telephone | 919-876-8140
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CARMEN FOSTER MCLEAN
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Credential | M.D.
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Telephone | 919-876-8140
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 2009-00310
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License Number State | NC
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