Provider Demographics
NPI:1275735888
Name:MCLEOD, ANDREW D (OD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:D
Last Name:MCLEOD
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:99 BEDFORD ST LBBY 102
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02111-2210
Mailing Address - Country:US
Mailing Address - Phone:617-426-0370
Mailing Address - Fax:617-426-4924
Practice Address - Street 1:99 BEDFORD STREET
Practice Address - Street 2:STE 102
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02211
Practice Address - Country:US
Practice Address - Phone:617-426-0370
Practice Address - Fax:617-426-4924
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA4586152W00000X
MAOPT4546152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0001919OtherMEDICARE
MAW16515OtherBLUE CROSS BLUE SHIELD
MA0715255Medicaid
MAAA101658OtherHARVARD PILGRIM