1225218506 NPI number — MARK D. KLAIMAN, M.D., L.C.

Table of content: ALEXI ELIZABETH WEAVER LCDC (NPI 1861122558)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225218506 NPI number — MARK D. KLAIMAN, M.D., L.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MARK D. KLAIMAN, M.D., L.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225218506
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/24/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6410 ROCKLEDGE DR
Provider Second Line Business Mailing Address:
SUITE 210
Provider Business Mailing Address City Name:
BETHESDA
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20817-1809
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-493-8884
Provider Business Mailing Address Fax Number:
301-493-8234

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6410 ROCKLEDGE DR
Provider Second Line Business Practice Location Address:
SUITE 210
Provider Business Practice Location Address City Name:
BETHESDA
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20817-1809
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-493-8884
Provider Business Practice Location Address Fax Number:
301-493-8234
Provider Enumeration Date:
11/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
KLAIMAN
Authorized Official First Name:
MARK
Authorized Official Middle Name:
D
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
301-493-8884

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  D45062 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1881698488 . This is a "NPI INDIVIDUAL" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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