Healthcare Provider Details

I. General information

NPI: 1508868241
Provider Name (Legal Business Name): LEWIS R KLINE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2005
Last Update Date: 10/07/2020
Certification Date: 10/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4815 LIBERTY AVE STE 250
PITTSBURGH PA
15224-2156
US

IV. Provider business mailing address

4815 LIBERTY AVE STE 250
PITTSBURGH PA
15224-2156
US

V. Phone/Fax

Practice location:
  • Phone: 724-671-1002
  • Fax: 724-671-1003
Mailing address:
  • Phone: 724-671-1002
  • Fax: 724-671-1003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberMD-025832-E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: