Individual
DR. DANIEL L MCCLELLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2544 COURT DR, SUITE G, GASTONIA, NC 28054-3450
(704) 864-7821
(704) 865-0519
Mailing address
2544 COURT DR, SUITE G, GASTONIA, NC 28054-3450
(704) 864-7821
(704) 865-0519
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
39851
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8955767
—
NC
01
—
N39851
SC MEDICAID
SC
Enumeration date
07/21/2006
Last updated
04/27/2010
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