Healthcare Provider Details

I. General information

NPI: 1093631798
Provider Name (Legal Business Name): MARC KLEIN M.D. P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4457 WATERBURY LN
MARIETTA GA
30062-8140
US

IV. Provider business mailing address

4457 WATERBURY LN
MARIETTA GA
30062-8140
US

V. Phone/Fax

Practice location:
  • Phone: 404-388-8814
  • Fax: 678-604-8412
Mailing address:
  • Phone: 404-388-8814
  • Fax: 678-604-8412

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MARC KLEIN
Title or Position: PRESIDENT
Credential:
Phone: 770-622-9100