Healthcare Provider Details

I. General information

NPI: 1669799797
Provider Name (Legal Business Name): MICHAEL SCOTT KLEINMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2010
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3237 BLUE RIDGE RD
RALEIGH NC
27612-8010
US

IV. Provider business mailing address

3237 BLUE RIDGE RD
RALEIGH NC
27612-8010
US

V. Phone/Fax

Practice location:
  • Phone: 901-758-7888
  • Fax: 901-266-6445
Mailing address:
  • Phone: 901-758-7888
  • Fax: 901-266-6445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number49710
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number49710
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: