Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | N003574 | NY |
NPI | 1205975133 |
---|---|
Provider Name | Dr. Robert Alan Klein |
First Address | Eden, NC 27288-5015 |
Second Address | Eden, NC 27288-5015 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2007 |
Last Update Date | 21/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
163 | NORTH CAROLINA LICENSE (01) | NC |
T51135 | (02) | NY |