Individual
DR. CHARLES D MACLEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
87 MAIN ST, ESSEX JUNCTION, VT 05452-3234
(802) 847-8354
Mailing address
280 COUNTRY LN, SHELBURNE, VT 05482-6932
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
420007816
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006102
—
VT
05
—
01096491
—
NY
01
—
42-0007816
STATE OF VT LICENSE
VT
Enumeration date
07/17/2006
Last updated
03/07/2023
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