Male or Other

Nathaniel H. Mcclellan MT

Specialist in Portland, ME(View on Map)

Full Name

Nathaniel H Mcclellan MT

NPI Number

1295856490

NPI Type

Individual Provider

Gender

Male

Enumeration Date

04/03/2007

Specialties

(Taxonomies)

Code

174400000X

Primary Taxonomy

Yes

Licenses

State

Maine

License Number

MT3072

Contact
Information

Purpose

Mailing
Location

Address

19 TEMPLE ST
19 TEMPLE ST

City

Portland
Portland

State

ME
ME

Postal Code

04101-4011
04101-4011

Country

US
US

Telephone Number

(207) 773-8393
(207) 773-8393

Identifiers

Identifier

099082

Identifier State

ME

Identifier Issuer

ANTHEM

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 07/08/2007

Provider Address

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