MEDICARE: DR. VANESSA KLEINER 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
1	207Q00000X	Family Medicine Physician	48312	WI

Other Identifiers

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

General Provider Information

NPI Number	:	1689646176
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VANESSA KLEINER M.D.

Provider Business Mailing Address
First Line	:	5760 N BAY RIDGE AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53217-4718
Country	:	US
Telephone Number	:	414-967-9569
Fax Number	:

Provider Business Practice Location Address
First Line	:	3070 N 51ST ST
Second Line	:	SUITE 510
City	:	MILWAUKEE
State	:	WI
Zip	:	53210-1645
Country	:	US
Telephone Number	:	414-447-3470
Fax Number	:	414-447-3471

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

Provider Enumeration Date	:	02/07/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. VANESSA KLEINER M.D.” Practice Location

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