1942284740 NPI number — KLEIN MD HUG MD SABIN MD MADDENS MD & KHOGALI-JAKARY DO PC

Table of content: (NPI 1942284740)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942284740 NPI number — KLEIN MD HUG MD SABIN MD MADDENS MD & KHOGALI-JAKARY DO PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KLEIN MD HUG MD SABIN MD MADDENS MD & KHOGALI-JAKARY DO PC
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:
NORTON KLEIN HUG SABIN MADDENS MD PC
Provider Other Organization Name Type Code:
4
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:
1942284740
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/17/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3290 W BIG BEAVER RD
Provider Second Line Business Mailing Address:
STE 420
Provider Business Mailing Address City Name:
TROY
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48084-2903
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-649-9700
Provider Business Mailing Address Fax Number:
248-649-9745

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3290 W BIG BEAVER RD
Provider Second Line Business Practice Location Address:
STE 420
Provider Business Practice Location Address City Name:
TROY
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48084-2903
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-649-9700
Provider Business Practice Location Address Fax Number:
248-649-9745
Provider Enumeration Date:
12/05/2005

Additional Information

Authorized Official

Authorized Official Last Name:
EVANS
Authorized Official First Name:
DENISE
Authorized Official Middle Name:
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
248-649-8058

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2024 www.npivalidator.com