Provider Demographics
NPI:1326060856
Name:KLEIN, JONATHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:
Last Name:KLEIN
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 1:6400 ARLINGTON BLVD
Mailing Address - Street 2:SUITE 940
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-2325
Mailing Address - Country:US
Mailing Address - Phone:703-241-1010
Mailing Address - Fax:703-241-7723
Practice Address - Street 1:6400 ARLINGTON BLVD
Practice Address - Street 2:SUITE 940
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-2325
Practice Address - Country:US
Practice Address - Phone:703-241-1010
Practice Address - Fax:703-241-7723
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101039553174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC491175Medicare ID - Type UnspecifiedINTERNAL MEDICINE
DC491175Medicare ID - Type UnspecifiedGERIATRIC