Provider Demographics
NPI:1457495806
Name:MCLEAN, LEON P (MD)
Entity Type:Individual
Prefix:DR
First Name:LEON
Middle Name:P
Last Name:MCLEAN
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 1:6 TSIENNETO RD STE 301
Mailing Address - Street 2:
Mailing Address - City:DERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03038-1584
Mailing Address - Country:US
Mailing Address - Phone:603-432-8802
Mailing Address - Fax:603-437-0118
Practice Address - Street 1:6 TSIENNETO RD STE 301
Practice Address - Street 2:
Practice Address - City:DERRY
Practice Address - State:NH
Practice Address - Zip Code:03038-1584
Practice Address - Country:US
Practice Address - Phone:603-432-8802
Practice Address - Fax:603-432-8802
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHNH17841207RG0100X
MDD70865207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH420209100Medicaid
NH192759Y1PMedicare PIN
MD192759Y1PMedicare PIN