MEDICARE: PATRICIA MILLS KLEIN P.A.-C

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	363AM0700X	Medical Physician Assistant	101115	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00391426	OTHER	NC	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	101115	OTHER	NC	MEDICAL LICENSE

General Provider Information

NPI Number	:	1184628745
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA MILLS KLEIN P.A.-C

Provider Business Mailing Address
First Line	:	1701 WESTCHESTER DR
Second Line	:	STE 850
City	:	HIGH POINT
State	:	NC
Zip	:	27262-7254
Country	:	US
Telephone Number	:	336-802-2400
Fax Number	:	336-802-2001

Provider Business Practice Location Address
First Line	:	3333 BROOKVIEW HILLS BLVD
Second Line	:	STE 207
City	:	WINSTON-SALEM
State	:	NC
Zip	:	27103-5661
Country	:	US
Telephone Number	:	336-765-5250
Fax Number	:	336-659-0953

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

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	06/25/2009

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Directions to “ PATRICIA MILLS KLEIN P.A.-C” Practice Location

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