Provider Demographics
NPI:1003079476
Name:KLEINMAN, BENJAMIN J (DPM)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:J
Last Name:KLEINMAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5205 EAST DR
Mailing Address - Street 2:SUITE I
Mailing Address - City:ARBUTUS
Mailing Address - State:MD
Mailing Address - Zip Code:21227-2403
Mailing Address - Country:US
Mailing Address - Phone:410-247-5333
Mailing Address - Fax:410-242-5449
Practice Address - Street 1:5205 EAST DR
Practice Address - Street 2:STE. I
Practice Address - City:ARBUTUS
Practice Address - State:MD
Practice Address - Zip Code:21227-2403
Practice Address - Country:US
Practice Address - Phone:410-247-5333
Practice Address - Fax:410-242-5449
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-07
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01512213ES0103X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD451607900Medicaid
MD245873Medicare PIN