Individual
DR. SHAUN R MCCLENNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1625 CROFTON CTR, CROFTON, MD 21114-1318
(410) 451-3561
(410) 451-2265
Mailing address
PO BOX 3788, CROFTON, MD 21114-3788
(410) 451-3561
(410) 451-2265
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
03452
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
260119934
TAX ID
MD
01
—
64671401
CAREFIRST RENDERING #
MD
01
—
K7710001
CAREFIRST XIP
MD
Enumeration date
03/21/2007
Last updated
04/21/2010
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