Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | MT216782 | PA |
Y | 111NI0900X | Internist | MT216782 | PA |
NPI | 1003301037 |
---|---|
Provider Name | Harrison Klause |
First Address | Bethlehem, PA 18018-6140 |
Second Address | Allentown, PA 18103-6202 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2018 |
Last Update Date | 22/06/2018 |