Individual
DR. JOHN MATHESON MCLELLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MDCM
Contact information
Practice address
140 HOSPITAL DR, BENNINGTON, VT 05201-5009
(802) 442-8182
Mailing address
140 HOSPITAL DR, BENNINGTON, VT 05201-5009
(802) 442-8182
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
042-0005310
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0004563
—
VT
01
—
03-0354915
TAX ID
VT
Enumeration date
11/01/2006
Last updated
04/30/2008
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