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NPI Code Detail

MEDICARE: MITCHELL A KLEIN MD

MEDICARE:   MITCHELL A KLEIN  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
12085R0202XDiagnostic Radiology Physician31140WI

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 : 1912056086
Entity Type Code : Individual
Provider Name (Legal Business Name) : MITCHELL A KLEIN MD
Provider Business Mailing Address
First Line : 10936 N PORT WASHINGTON RD
Second Line : #208
City : MEQUON
State : WI
Zip : 53092-5031
Country : US
Telephone Number : 414-768-5430
Fax Number :
Provider Business Practice Location Address
First Line : 2000 E LAYTON AVE
Second Line : #130
City : MILWAUKEE
State : WI
Zip : 53235-6053
Country : US
Telephone Number : 414-747-8856
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2007
Last Update Date : 07/08/2007

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Directions to “ MITCHELL A KLEIN MD” Practice Location

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