MEDICARE: ROBERT KLASE PAC

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	363A00000X	Physician Assistant	0110001478	VA

General Provider Information

NPI Number	:	1346210309
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT KLASE PAC

Provider Business Mailing Address
First Line	:	7858 SHRADER RD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23294-4222
Country	:	US
Telephone Number	:	804-270-1305
Fax Number	:

Provider Business Practice Location Address
First Line	:	7858 SHRADER RD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23294-4222
Country	:	US
Telephone Number	:	804-270-1305
Fax Number	:	804-273-9294

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

Provider Enumeration Date	:	01/24/2006
Last Update Date	:	03/07/2023

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Directions to “ ROBERT KLASE PAC” Practice Location

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