Provider Demographics
NPI:1235573916
Name:MCCLAIN, THERESA (DO)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:
Last Name:MCCLAIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2494 BERNVILLE RD
Mailing Address - Street 2:STE 100
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19605-9466
Mailing Address - Country:US
Mailing Address - Phone:610-378-2899
Mailing Address - Fax:610-378-2980
Practice Address - Street 1:1611 POND RD STE 300
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104
Practice Address - Country:US
Practice Address - Phone:610-398-7700
Practice Address - Fax:610-398-3917
Is Sole Proprietor?:No
Enumeration Date:2013-04-24
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS018924207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology