Provider Demographics
NPI:1548299688
Name:MACLEAN, DUNCAN S (MD)
Entity type:Individual
Prefix:DR
First Name:DUNCAN
Middle Name:S
Last Name:MACLEAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1700 SOUTH LINCOLN AVE.
Mailing Address - Street 2:LEBANON VA MEDICAL CENTER
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17042-9970
Mailing Address - Country:US
Mailing Address - Phone:800-409-8771
Mailing Address - Fax:717-228-6156
Practice Address - Street 1:1700 SOUTH LINCOLN AVE
Practice Address - Street 2:LEBANON VA MEDICAL CENTER
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-9970
Practice Address - Country:US
Practice Address - Phone:800-409-8771
Practice Address - Fax:717-228-6156
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10005629207R00000X
PAMD018732E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
C29467Medicare UPIN
DEC29467Medicare UPIN
DE458079Medicare ID - Type Unspecified