Provider Demographics
NPI:1144398314
Name:MCLEOD, MALCOLM NOELL (MD MBA)
Entity Type:Individual
Prefix:DR
First Name:MALCOLM
Middle Name:NOELL
Last Name:MCLEOD
Suffix:
Gender:M
Credentials:MD MBA
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:901 WILLOW DR
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-7078
Mailing Address - Country:US
Mailing Address - Phone:919-967-9112
Mailing Address - Fax:919-929-6085
Practice Address - Street 1:901 WILLOW DR
Practice Address - Street 2:SUITE 3
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-7078
Practice Address - Country:US
Practice Address - Phone:919-967-9112
Practice Address - Fax:919-929-6085
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC147362084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
C81705Medicare UPIN
NC203194Medicare ID - Type Unspecified