Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0216X | Pediatric Rheumatologist | 5101026041 | MI |
NPI | 1427410737 |
---|---|
Provider Name | Nicholas John Mcclellan |
First Address | Ann Arbor, MI 48109-5718 |
Second Address | Ann Arbor, MI 48109-5718 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2016 |
Last Update Date | 07/07/2021 |