Healthcare Provider Details

I. General information

NPI: 1194880534
Provider Name (Legal Business Name): CAROL LYNN KLEIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 LLOYD ST
CARRBORO NC
27510-1823
US

IV. Provider business mailing address

808 CREEKSTONE DR
CHAPEL HILL NC
27516-9630
US

V. Phone/Fax

Practice location:
  • Phone: 919-942-8741
  • Fax: 919-942-1473
Mailing address:
  • Phone: 919-967-9391
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25152
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: