Healthcare Provider Details

I. General information

NPI: 1285683797
Provider Name (Legal Business Name): ADAM P. KLAUSNER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 02/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 E BROAD ST DIVISION OF UROLOGY, WEST HOSPITAL, 7TH FLR., EAST WING
RICHMOND VA
23298-5058
US

IV. Provider business mailing address

2313 FOUNDERS BRIDGE RD
MIDLOTHIAN VA
23113-6379
US

V. Phone/Fax

Practice location:
  • Phone: 804-828-9331
  • Fax:
Mailing address:
  • Phone: 804-897-8752
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number0101232759
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: