Provider Demographics
NPI:1245223882
Name:KLEINMAN, ROBERT LESLIE (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:LESLIE
Last Name:KLEINMAN
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 1:323 HIGH ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:WADSWORTH
Mailing Address - State:OH
Mailing Address - Zip Code:44281-1869
Mailing Address - Country:US
Mailing Address - Phone:330-335-1586
Mailing Address - Fax:330-336-4236
Practice Address - Street 1:323 HIGH ST
Practice Address - Street 2:SUITE C
Practice Address - City:WADSWORTH
Practice Address - State:OH
Practice Address - Zip Code:44281-1869
Practice Address - Country:US
Practice Address - Phone:330-335-1586
Practice Address - Fax:330-336-4236
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.048769207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0529315Medicaid
OHP00398943OtherRAILROAD MEDICARE PIN
OH0529315Medicaid
OH0532233Medicare PIN
OH0529315Medicaid