Provider Demographics
NPI:1003968405
Name:KLEEMAN, JAMES CHARLES JR (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:CHARLES
Last Name:KLEEMAN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7505 OSLER DR
Mailing Address - Street 2:SUITE 308
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204
Mailing Address - Country:US
Mailing Address - Phone:410-296-1464
Mailing Address - Fax:410-296-1480
Practice Address - Street 1:7505 OSLER DR
Practice Address - Street 2:SUITE 308
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204
Practice Address - Country:US
Practice Address - Phone:410-296-1464
Practice Address - Fax:410-296-1480
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD16501207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
C49244Medicare UPIN
P614Medicare ID - Type Unspecified