MEDICARE: DR. PETER KLAINER 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	174400000X	Specialist	0101055546	VA
2	208200000X	Plastic Surgery Physician	2016-00315	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	541966772	OTHER	PRIVATE HEALTHCARE SYSTEM
2	64610001	OTHER	CARE FIRST BCBS
3	2236381	OTHER	AETNA HMO
4	5474627	OTHER	AETNA PPO
5	541966772	OTHER	NCPPO
6	118767	OTHER	ANTHEM BCBS

General Provider Information

NPI Number	:	1982765939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PETER KLAINER M.D.

Provider Business Mailing Address
First Line	:	3700 SYMI CIR
Second Line	:
City	:	MOREHEAD CITY
State	:	NC
Zip	:	28557-4309
Country	:	US
Telephone Number	:	252-222-5888
Fax Number	:	252-773-0506

Provider Business Practice Location Address
First Line	:	3700 SYMI CIR
Second Line	:
City	:	MOREHEAD CITY
State	:	NC
Zip	:	28557-4309
Country	:	US
Telephone Number	:	252-222-5888
Fax Number	:	252-773-0506

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

Provider Enumeration Date	:	12/13/2006
Last Update Date	:	06/09/2016

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Directions to “ DR. PETER KLAINER M.D.” Practice Location

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