MEDICARE: DR. CAROL COLE KLEINMAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	D26772	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	23208	OTHER	MD	MAMSI

General Provider Information

NPI Number	:	1184621690
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CAROL COLE KLEINMAN MD

Provider Business Mailing Address
First Line	:	5480 WISCONSIN AVE
Second Line	:
City	:	CHEVY CHASE
State	:	MD
Zip	:	20815-3533
Country	:	US
Telephone Number	:	301-654-1810
Fax Number	:	301-656-2137

Provider Business Practice Location Address
First Line	:	5480 WISCONSIN AVE
Second Line	:
City	:	CHEVY CHASE
State	:	MD
Zip	:	20815-3530
Country	:	US
Telephone Number	:	301-654-1810
Fax Number	:	301-656-2137

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	07/08/2007

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