MEDICARE: DR. CHRISTOPHER SCOTT KLEEMAN 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	207R00000X	Internal Medicine Physician	MD430574	PA
2	207RG0100X	Gastroenterology Physician	MD430574	PA
3	207RG0100X	Gastroenterology Physician	018451	ME

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861690471
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER SCOTT KLEEMAN M.D.

Provider Business Mailing Address
First Line	:	25 LONG CREEK DR
Second Line	:
City	:	SOUTH PORTLAND
State	:	ME
Zip	:	04106-2449
Country	:	US
Telephone Number	:	207-553-6880
Fax Number	:	207-879-0095

Provider Business Practice Location Address
First Line	:	25 LONG CREEK DR
Second Line	:
City	:	SOUTH PORTLAND
State	:	ME
Zip	:	04106-2449
Country	:	US
Telephone Number	:	207-553-6880
Fax Number	:	207-879-0095

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

Provider Enumeration Date	:	07/05/2007
Last Update Date	:	02/07/2011

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Directions to “ DR. CHRISTOPHER SCOTT KLEEMAN M.D.” Practice Location

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