MEDICARE: DR. CARLA BELTRAN MACLEOD MD

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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	D0042212	MD
2	207ZC0500X	Cytopathology Physician	D0042212	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1699774497
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARLA BELTRAN MACLEOD MD

Provider Business Mailing Address
First Line	:	PO BOX 1738
Second Line	:
City	:	WAKE FOREST
State	:	NC
Zip	:	27588-1738
Country	:	US
Telephone Number	:	301-926-4707
Fax Number	:	201-926-4708

Provider Business Practice Location Address
First Line	:	18207A FLOWER HILL WAY
Second Line	:
City	:	GAITHERSBURG
State	:	MD
Zip	:	20879-5331
Country	:	US
Telephone Number	:	301-926-4707
Fax Number	:	301-926-4708

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	11/18/2014

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