Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | G58946 | CA |
NPI | 1235259888 |
---|---|
Provider Name | Dr. William Roland Klemme |
First Address | Greenbrae, CA 94904-3017 |
Second Address | Greenbrae, CA 94904-3017 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DE2303 | RAILROAD MEDICARE PART B (01) | |
F71720 | (02) |