MEDICARE: DAWN ELIZABETH KLEINMAN 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	207N00000X	Dermatology Physician	9801337	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	9801337	OTHER	NC	NORTH CAROLINA MEDICAL LICENSE

General Provider Information

NPI Number	:	1629164850
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAWN ELIZABETH KLEINMAN MD

Provider Business Mailing Address
First Line	:	1911 K M WICKER MEMORIAL DR
Second Line	:
City	:	SANFORD
State	:	NC
Zip	:	27330-5070
Country	:	US
Telephone Number	:	919-775-7926
Fax Number	:	919-718-0092

Provider Business Practice Location Address
First Line	:	1911 K M WICKER MEMORIAL DR
Second Line	:
City	:	SANFORD
State	:	NC
Zip	:	27330-5070
Country	:	US
Telephone Number	:	919-775-7926
Fax Number	:	919-718-0092

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

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	07/20/2022

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