Physician Compare National (NPI:1093840811)

HEALTHCARE PROVIDER: MARK ALLEN MCCLANAHAN M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1093840811
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5092991398
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110523000372
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MCCLANAHAN
	Individual professional last name
Provider First Name	MARK
	Individual professional first name
Provider Middle Name	A
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	VIRGINIA COMMONWEALTH UNIVERSITY, SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1986
	Individual professional's medical school graduation year
Primary Specialty	ENDOCRINOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	10711 SPOTSYLVANIA AVE
	Group Practice or individual's line 1 address
City	FREDERICKSBURG
	Group Practice or individual's city
State	VA
	Group Practice or individual's state
Zip Code	224082674
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	490022
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MARY WASHINGTON HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	490140
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	STAFFORD HOSPITAL, LLC
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	490141
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	SPOTSYLVANIA REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y