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Individual

DEREK A MCCLELLAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
507 EXECUTIVE CAMPUS DR, SUITE 160, WESTERVILLE, OH 43082-9838
(614) 891-9505
(614) 891-6416
Mailing address
507 EXECUTIVE CAMPUS DR, SUITE 160, WESTERVILLE, OH 43082-9838
(614) 891-9505
(614) 891-6416

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35.35075108
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2160781
OH
Enumeration date
07/12/2006
Last updated
09/15/2008
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