Provider Demographics
NPI:1700144649
Name:MACLEAN, BRETT L (MD)
Entity type:Individual
Prefix:
First Name:BRETT
Middle Name:L
Last Name:MACLEAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 IVY BROOK LN
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-8084
Mailing Address - Country:US
Mailing Address - Phone:919-827-1227
Mailing Address - Fax:
Practice Address - Street 1:10327 US 15 501 N STE A
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-6467
Practice Address - Country:US
Practice Address - Phone:919-525-2844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-29
Last Update Date:2025-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCMMD.23462208000000X
TXU0618208000000X
AZ67907208000000X
NC2014-00986208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics