Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 18003121B | IN |
NPI | 1225165905 |
---|---|
Provider Name | Dr. Angeline Mclean |
First Address | Carmel, IN 46032-2102 |
Second Address | Carmel, IN 46032-2102 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U92996 | (02) | IN |