MEDICARE: MCLEOD BUSINESS GROUP, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171W00000X	Contractor

General Provider Information

NPI Number	:	1659664761
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MCLEOD BUSINESS GROUP, INC.

Provider Business Mailing Address
First Line	:	1425 K ST NW
Second Line	:	SUITE 350
City	:	WASHINGTON
State	:	DC
Zip	:	20005-3500
Country	:	US
Telephone Number	:	202-669-3023
Fax Number	:

Provider Business Practice Location Address
First Line	:	1425 K ST NW
Second Line	:	SUITE 350
City	:	WASHINGTON
State	:	DC
Zip	:	20005-3500
Country	:	US
Telephone Number	:	202-669-3023
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT CEO
Name	:	MR. BOBBY THOMAS MCLEOD
Credential	:
Telephone Number	:	202-669-3023

Provider Enumeration Date	:	05/23/2011
Last Update Date	:	05/23/2011

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Directions to “MCLEOD BUSINESS GROUP, INC. ” Practice Location

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