Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 26791 | MA |
NPI | 1073680708 |
---|---|
Provider Name | Walter L Mclean |
First Address | West Falmouth, MA 02574-0843 |
Second Address | West Falmouth, MA 02540 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2006 |
Last Update Date | 11/12/2012 |