Healthcare Provider Details

I. General information

NPI: 1942216163
Provider Name (Legal Business Name): GEORGE THOMAS KLAUBER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 01/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 WASHINGTON ST # 92 TUFTS MEDICAL CENTER
BOSTON MA
02111-1552
US

IV. Provider business mailing address

23 FAYETTE STREET
BOSTON MA
02116-5518
US

V. Phone/Fax

Practice location:
  • Phone: 617-636-5360
  • Fax: 617-636-4267
Mailing address:
  • Phone: 617-482-3032
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMA44892
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberMA44892
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: