Healthcare Provider Details

I. General information

NPI: 1184628745
Provider Name (Legal Business Name): PATRICIA MILLS KLEIN P.A.-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2005
Last Update Date: 06/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BROOKVIEW HILLS BLVD STE 207
WINSTON-SALEM NC
27103-5661
US

IV. Provider business mailing address

1701 WESTCHESTER DR STE 850
HIGH POINT NC
27262-7254
US

V. Phone/Fax

Practice location:
  • Phone: 336-765-5250
  • Fax: 336-659-0953
Mailing address:
  • Phone: 336-802-2400
  • Fax: 336-802-2001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number101115
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: