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Individual

MICHAEL MCLAIN TODD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
19465 DEERFIELD AVE, SUITE 401, LEESBURG, VA 20176-1701
(703) 723-5700
(703) 723-5778
Mailing address
PO BOX 17334, BALTIMORE, MD 21297-1334
(703) 443-6717
(703) 443-8643

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
0101235935
VA
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
0101235935
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010075424
VA
01
P00307175
RR MEDICARE
VA
Enumeration date
09/08/2005
Last updated
03/10/2010
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