MEDICARE: RONALD A MCLEAN MD PC

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	207Q00000X	Family Medicine Physician	36684	CO

General Provider Information

NPI Number	:	1922135144
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RONALD A MCLEAN MD PC

Provider Business Mailing Address
First Line	:	7960 S UNIVERSITY BLVD STE 101
Second Line	:
City	:	CENTENNIAL
State	:	CO
Zip	:	80122-3167
Country	:	US
Telephone Number	:	303-791-0301
Fax Number	:

Provider Business Practice Location Address
First Line	:	7960 S UNIVERSITY BLVD STE 101
Second Line	:
City	:	CENTENNIAL
State	:	CO
Zip	:	80122-3167
Country	:	US
Telephone Number	:	303-791-0301
Fax Number	:

Authorized Official
Title or Position	:	MD
Name	:	RONALD MCLEAN
Credential	:
Telephone Number	:	303-791-0301

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	08/27/2007

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