Provider Demographics
NPI:1720078066
Name:MCLEOD, MICHAEL M (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:M
Last Name:MCLEOD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 FARRINGTON CORNER RD
Mailing Address - Street 2:
Mailing Address - City:HOPKINTON
Mailing Address - State:NH
Mailing Address - Zip Code:03229-2020
Mailing Address - Country:US
Mailing Address - Phone:603-228-7575
Mailing Address - Fax:603-228-7585
Practice Address - Street 1:19 FARRINGTON CORNER RD
Practice Address - Street 2:
Practice Address - City:HOPKINTON
Practice Address - State:NH
Practice Address - Zip Code:03229-2020
Practice Address - Country:US
Practice Address - Phone:603-228-7575
Practice Address - Fax:603-228-7585
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH11968207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5900268Medicaid
NC138U1OtherBCBS NC
NCH80325Medicare UPIN
NC5900268Medicaid