Healthcare Provider Details
I. General information
NPI: 1043498892
Provider Name (Legal Business Name): RODNEY HUGH KLASSEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/04/2008
Last Update Date: 02/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1 LOWER NAVY HILL
SAIPAN MP
96950-0409
US
IV. Provider business mailing address
PO BOX 500409
SAIPAN MP
96950-0409
US
V. Phone/Fax
- Phone: 670-234-8950
- Fax:
- Phone: 670-234-8950
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | 0340 |
| License Number State | MP |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: