Provider Demographics
NPI:1437106127
Name:MACLEAN, MICHELE B (MD)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:B
Last Name:MACLEAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6850 QUINPOOL ROAD
Mailing Address - Street 2:
Mailing Address - City:HALIFAX
Mailing Address - State:NS
Mailing Address - Zip Code:B3L1C4
Mailing Address - Country:CA
Mailing Address - Phone:902-362-2021
Mailing Address - Fax:
Practice Address - Street 1:KENNETCOOK MEDICAL CLINIC
Practice Address - Street 2:6202 HIGHWAY 354
Practice Address - City:KENNETCOOK
Practice Address - State:NS
Practice Address - Zip Code:B0W1P0
Practice Address - Country:CA
Practice Address - Phone:902-362-2021
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA158427207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine