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General NPI Number Information
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NPI Number | 1437594272
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Entity Type | Organization
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Legal Business Name | ALEXANDRA B. MCLEAN, M.D., PC
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Dates
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Enumeration Date | 05/07/2013
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Last Update Date | 05/18/2013
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Provider Practice Location Address
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Address Line | 121 COULTER AVE 207
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City | ARDMORE
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State | PA
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Zip | 19003-2418
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Country | US
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Telephone | 610-896-9870
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Fax | 610-896-9871
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Provider Business Mailing Address
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Address Line | 121 COULTER AVE 207
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City | ARDMORE
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State | PA
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Zip | 19003-2418
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Country | US
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Telephone | 610-896-9870
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Fax | 610-896-9871
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Authorized Official
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Title or Position | OWNER
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Name | DR. ALEXANDRA B MCLEAN
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Credential | MD
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Telephone | 610-896-9870
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number | MD057719L
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License Number State | PA
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