Provider Demographics
NPI:1750659298
Name:MCLEAN, DONALD CASSCLES (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:CASSCLES
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 1:3426 COCHISE DR SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-4324
Mailing Address - Country:US
Mailing Address - Phone:770-438-0024
Mailing Address - Fax:770-438-0024
Practice Address - Street 1:1938 PEACHTREE RD NW STE 507
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1254
Practice Address - Country:US
Practice Address - Phone:404-351-7520
Practice Address - Fax:404-355-2048
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-13
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA12261174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty