Healthcare Provider Details

I. General information

NPI: 1508833187
Provider Name (Legal Business Name): MICHELLE A KLAUMANN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2006
Last Update Date: 01/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 HIGHWAY 95 STE 200
BULLHEAD CITY AZ
86442-6057
US

IV. Provider business mailing address

6 EXECUTIVE PARK DR NE SUITE10
ATLANTA GA
30329-2221
US

V. Phone/Fax

Practice location:
  • Phone: 928-758-1175
  • Fax: 928-758-5191
Mailing address:
  • Phone: 404-321-9900
  • Fax: 404-321-4460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number04-22351
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: