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NPI Code Detail

MEDICARE: ALAN D KLEIN M.D.

MEDICARE: ALAN D KLEIN M.D.
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
1207N00000XDermatology Physician200101456NC

Other Identifiers

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

General Provider Information

NPI Number : 1497756647
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALAN D KLEIN M.D.
Provider Business Mailing Address
First Line : 2020 PEACE HAVEN RD
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27106-4851
Country : US
Telephone Number : 336-768-1280
Fax Number : 336-760-8443
Provider Business Practice Location Address
First Line : 2020 PEACE HAVEN RD
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27106-4851
Country : US
Telephone Number : 336-768-1280
Fax Number : 336-760-8443
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2005
Last Update Date : 09/18/2012

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