Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | D17515 | MD |
Y | 111NI0900X | Internist | D17515 | MD |
N | 207RH0000X | Hematologist | D17515 | MD |
N | 207RH0003X | Hematology & Oncology | MD028674E | PA |
NPI | 1073516415 |
---|---|
Provider Name | Mr. Michael Elihu Klein |
First Address | Jarrettsville, MD 21084-1838 |
Second Address | Jarrettsville, MD 21084-1838 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2005 |
Last Update Date | 23/08/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A85458 | (02) | PA |