Provider Demographics
NPI:1114053493
Name:MACLEOD, IAN DONALD (MD)
Entity Type:Individual
Prefix:DR
First Name:IAN
Middle Name:DONALD
Last Name:MACLEOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BOX 10001
Mailing Address - Street 2:PMB 3739
Mailing Address - City:SALPAN
Mailing Address - State:MP
Mailing Address - Zip Code:96950-8901
Mailing Address - Country:US
Mailing Address - Phone:670-234-8950
Mailing Address - Fax:
Practice Address - Street 1:1 LOWER NAVY HILL
Practice Address - Street 2:COMMONWEALTH HEALTH CENTER LOWER NAVY MILL
Practice Address - City:SAIPAN
Practice Address - State:MP
Practice Address - Zip Code:96950
Practice Address - Country:US
Practice Address - Phone:670-234-8950
Practice Address - Fax:670-236-8608
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MP0111207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine