Provider Demographics
NPI:1073666228
Name:KLIBANER, MICHAEL I (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:I
Last Name:KLIBANER
Suffix:
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 1:405 ANDREW RD
Mailing Address - Street 2:
Mailing Address - City:MERION STATION
Mailing Address - State:PA
Mailing Address - Zip Code:19066-1327
Mailing Address - Country:US
Mailing Address - Phone:302-885-8331
Mailing Address - Fax:
Practice Address - Street 1:ASTRAZENECA L.P.
Practice Address - Street 2:1800 CONCORD PIKE
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19850
Practice Address - Country:US
Practice Address - Phone:302-885-8331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA48340207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology