Provider Demographics
NPI:1992969885
Name:MCLEON, CLYDE (SA-)
Entity type:Individual
Prefix:MR
First Name:CLYDE
Middle Name:
Last Name:MCLEON
Suffix:
Gender:M
Credentials:SA-
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 STRATFORD RD
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-1845
Mailing Address - Country:US
Mailing Address - Phone:410-245-5127
Mailing Address - Fax:
Practice Address - Street 1:315 STRATFORD RD
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-1845
Practice Address - Country:US
Practice Address - Phone:410-245-5127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant