Individual
MR. MACON O'BRIAN MCCLEASE SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
600 GRESHAM DR, NORFOLK, VA 23507-1904
(757) 473-0055
(757) 473-0075
Mailing address
134 BUSINESS PARK AVE, VA BEACH, VA 23462-2626
(757) 473-0055
(757) 473-0075
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
0024
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
0024175722
VA
Other
Enumeration date
01/03/2018
Last updated
03/05/2018
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