Provider Demographics
NPI:1245200062
Name:KLUGER, DANIEL MARTIN (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:MARTIN
Last Name:KLUGER
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 1:856 J CLYDE MORRIS BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23601-1318
Mailing Address - Country:US
Mailing Address - Phone:757-316-5800
Mailing Address - Fax:757-534-5190
Practice Address - Street 1:12420 WARWICK BLVD STE 4C
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-3053
Practice Address - Country:US
Practice Address - Phone:757-569-7115
Practice Address - Fax:757-596-7127
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2017-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101224963207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA110204252OtherMEDICAR RAILROAD
VA005836972Medicaid
VA110007696Medicare ID - Type UnspecifiedMEDICARE ID
WA110204252OtherMEDICAR RAILROAD