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General NPI Number Information
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NPI Number | 1437361284
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Entity Type | Organization
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Legal Business Name | DEBORAH L KLIMEK, MD, PLLC
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 24 MACCORKLE AVE SW SUITE 203
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City | SOUTH CHARLESTON
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State | WV
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Zip | 25303-1476
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Country | US
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Telephone | 304-720-7001
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Fax |
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Provider Business Mailing Address
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Address Line | 24 MACCORKLE AVE SW SUITE 203
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City | SOUTH CHARLESTON
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State | WV
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Zip | 25303-1476
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DEBORAH KLIMEK
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Credential | MD
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Telephone | 304-720-7001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 55593
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License Number State | WV
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