Provider Demographics
NPI:1306817200
Name:KLINE, ELIZABETH MILLER (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:MILLER
Last Name:KLINE
Suffix:
Gender:F
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:PO BOX 751649
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1649
Mailing Address - Country:US
Mailing Address - Phone:843-789-1620
Mailing Address - Fax:843-724-2440
Practice Address - Street 1:2085 HENRY TECKLENBURG DR STE 310
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-7713
Practice Address - Country:US
Practice Address - Phone:843-720-8317
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC23465208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCP00754418OtherRAILROAD MC ID- RSFPN
SCP00648634OtherRAILROAD MEDICARE
SC234650Medicaid
SCP00754418OtherRAILROAD MC ID- RSFPN
SCP00648634OtherRAILROAD MEDICARE
SCH834395551Medicare PIN