Provider Demographics
NPI:1285683797
Name:KLAUSNER, ADAM P (MD)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:P
Last Name:KLAUSNER
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 1:2313 FOUNDERS BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-6379
Mailing Address - Country:US
Mailing Address - Phone:804-897-8752
Mailing Address - Fax:
Practice Address - Street 1:1200 E BROAD ST
Practice Address - Street 2:DIVISION OF UROLOGY, WEST HOSPITAL, 7TH FLR., EAST WING
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-5058
Practice Address - Country:US
Practice Address - Phone:804-828-9331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101232759208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010095921Medicaid
VAI11730Medicare UPIN
VA005630M98Medicare ID - Type Unspecified