Individual
DR. CHARLES D MACLEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
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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