Doctor Name: | DANIEL MAX MCLEAN |
NPI Number: | 1083955090 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MPAS, PA-C |
License Number: | |
Business Practice Address: | 11472 Kenai Spur Hwy Ste 2 Kenai, AK - 996117779 |
Business Phone Number: | 9072836030 |
Business Fax Number: | |
Mailing Address: | 36060 Ebb Tide Dr, KENAI |
State: | AK |
Postal Code: | 996118748 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 03/15/2013 |
NPI Last Update Date: | 11/26/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |