Provider Demographics
NPI:1205854478
Name:KLEIN, SHARI (DO)
Entity Type:Individual
Prefix:
First Name:SHARI
Middle Name:
Last Name:KLEIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1930 VILLAGE CENTER CIR # 3-968
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89134-6238
Mailing Address - Country:US
Mailing Address - Phone:702-566-5343
Mailing Address - Fax:702-566-4549
Practice Address - Street 1:8571 W LAKE MEAD BLVD
Practice Address - Street 2:#100
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-7644
Practice Address - Country:US
Practice Address - Phone:702-566-5343
Practice Address - Fax:702-566-4549
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2015-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV963207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV00201836Medicaid
NVH33516Medicare UPIN
NVV100813Medicare ID - Type UnspecifiedINDIVIDUAL PROVIDER NO.
NVV100813Medicare PIN