MEDICARE: DR. CAROLYN CHRISTINE KLAUS M.D.

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	207R00000X	Internal Medicine Physician	01046291A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811988561
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CAROLYN CHRISTINE KLAUS M.D.

Provider Business Mailing Address
First Line	:	3355 DOUGLAS RD
Second Line	:	STE. 300
City	:	SOUTH BEND
State	:	IN
Zip	:	46635-1781
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 NAVARRE PL
Second Line	:	STE. 4400
City	:	SOUTH BEND
State	:	IN
Zip	:	46601-1156
Country	:	US
Telephone Number	:	574-647-4535
Fax Number	:

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

Provider Enumeration Date	:	11/02/2005
Last Update Date	:	09/25/2008

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