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Individual

DR. JUAN NICOLAS MCLEAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1370 WELLBROOK CIR NE, CONYERS, GA 30012-3872
(770) 922-5458
(770) 922-0435
Mailing address
3532 LANTERN VIEW LN, SCOTTDALE, GA 30079-6806
(404) 274-6468

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
059289
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
059289
STATE OF GEORGIA LICENSE
GA
Enumeration date
05/21/2007
Last updated
07/08/2007
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