Provider Demographics
NPI:1225165905
Name:MCLEAN, ANGELINE (OD)
Entity type:Individual
Prefix:DR
First Name:ANGELINE
Middle Name:
Last Name:MCLEAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14250 CLAY TERRACE BLVD STE 160
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-3633
Mailing Address - Country:US
Mailing Address - Phone:317-844-2020
Mailing Address - Fax:
Practice Address - Street 1:14250 CLAY TERRACE BLVD STE 160
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-3633
Practice Address - Country:US
Practice Address - Phone:317-844-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18003121B152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
INU92996Medicare UPIN