Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 012600 | ME |
NPI | 1487638177 |
---|---|
Provider Name | Dr. Paul Kluger |
First Address | Brewer, ME 04412-1005 |
Second Address | Bangor, ME 04401-3083 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2005 |
Last Update Date | 12/12/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002412 | ANTHEM BLUE SHIELD (01) | ME |
040013980 | RAILROAD INDIV PROV # (01) | ME |
100224700 | DEPT OF LABOR GROUP # (01) | ME |
1040656 | AETNA INDIV # (01) | ME |
110570000 | (05) | ME |
110570001 | (05) | ME |
306530099 | (05) | ME |
620012901 | CIGNA INDIV # (01) | ME |
B58025 | (02) | ME |