# DR. CHARLES D MACLEAN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1619995792
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 420007816 | VT | Yes |

## Other

- **Enumeration date:** 07/17/2006
- **Last updated:** 03/07/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0006102 | — | VT |
| 05 | — | 01096491 | — | NY |
| 01 | — | 42-0007816 | STATE OF VT LICENSE | VT |