MEDICARE: DR. HARRIS L KLEAR D.P.M.

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	213ES0103X	Foot & Ankle Surgery Podiatrist	MD00925	NJ

General Provider Information

NPI Number	:	1538163134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HARRIS L KLEAR D.P.M.

Provider Business Mailing Address
First Line	:	750 ROUTE 73 S
Second Line	:	STE 103A
City	:	MARLTON
State	:	NJ
Zip	:	08053-4142
Country	:	US
Telephone Number	:	856-983-7200
Fax Number	:	856-983-6111

Provider Business Practice Location Address
First Line	:	750 ROUTE 73 S
Second Line	:	STE 103A
City	:	MARLTON
State	:	NJ
Zip	:	08053-4142
Country	:	US
Telephone Number	:	856-983-7200
Fax Number	:	856-983-6111

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

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	07/20/2010

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