Provider Demographics
NPI:1710142641
Name:MCLEAN, MARK DAVID (DO)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:DAVID
Last Name:MCLEAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:3292 PEORIA ST.
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80010-1517
Mailing Address - Country:US
Mailing Address - Phone:303-360-6276
Mailing Address - Fax:303-343-4058
Practice Address - Street 1:3292 PEORIA ST.
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80010-1517
Practice Address - Country:US
Practice Address - Phone:303-360-6276
Practice Address - Fax:303-343-4058
Is Sole Proprietor?:No
Enumeration Date:2008-07-21
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CODR44310208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice