=====================================================
General NPI Number Information
=====================================================
NPI Number | 1396182275
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NICHOLAS A KLAIBER MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/31/2013
-----------------------------------------------------
Last Update Date | 11/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 812 MOOREFIELD PARK DR STE 101
-----------------------------------------------------
City | NORTH CHESTERFIELD
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23236-3684
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 804-293-0917
-----------------------------------------------------
Fax | 840-244-3467
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 812 MOOREFIELD PARK DR STE 101
-----------------------------------------------------
City | NORTH CHESTERFIELD
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23236-3684
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-746-9974
-----------------------------------------------------
Fax | 840-244-3467
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207K00000X
-----------------------------------------------------
Taxonomy Name | Allergy & Immunology Physician
-----------------------------------------------------
License Number | 0101256787
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------