Basic Information
| Provider Information | |||||||||
| NPI: | 1518498765 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCLEAN | ||||||||
| FirstName: | CAMERON | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3 TOUNTAS AVE STE 4 | ||||||||
| Address2: | |||||||||
| City: | LE ROY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 144821368 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5857686530 | ||||||||
| FaxNumber: | 5857684593 | ||||||||
| Practice Location | |||||||||
| Address1: | 127 NORTH ST | ||||||||
| Address2: | |||||||||
| City: | BATAVIA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 140201631 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5853445412 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/21/2017 | ||||||||
| LastUpdateDate: | 12/11/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/11/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 296113 | NY | N | Allopathic & Osteopathic Physicians | Hospitalist | 207Q00000X | 296113 | NY | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.