MEDICARE: JOHN T KLIMAS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207K00000X	Allergy & Immunology Physician	0020737	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013956846
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN T KLIMAS MD

Provider Business Mailing Address
First Line	:	PO BOX 63376
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28263-3376
Country	:	US
Telephone Number	:	704-372-7900
Fax Number	:	704-376-2216

Provider Business Practice Location Address
First Line	:	2600 E 7TH ST
Second Line	:	UNIT A
City	:	CHARLOTTE
State	:	NC
Zip	:	28204-4375
Country	:	US
Telephone Number	:	704-372-7900
Fax Number	:	704-376-2216

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2006
Last Update Date	:	10/26/2016

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