Provider Demographics
NPI:1376529222
Name:KLEIN, MARC DAVID (DPM)
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:DAVID
Last Name:KLEIN
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:386 MERRIMACK ST STE 1B
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-5802
Mailing Address - Country:US
Mailing Address - Phone:978-682-0382
Mailing Address - Fax:978-975-3585
Practice Address - Street 1:386 MERRIMACK ST STE 1B
Practice Address - Street 2:
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-5802
Practice Address - Country:US
Practice Address - Phone:978-682-0382
Practice Address - Fax:978-975-3585
Is Sole Proprietor?:No
Enumeration Date:2005-12-21
Last Update Date:2014-07-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA1567213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
202669700OtherUSP DEPARTMENT OF LABOR
0004928OtherNEIGHBORHOOD HEALTH PLANS
MA0341703Medicaid
NH48054400OtherBLUE CROSS NH MEDICOMP
447OtherSENIOR WHOLE HEALTH
98131603OtherNETWORK HEALTH
P00379545OtherMEDICARE RAILROAD
MAY70671OtherBLUE CROSS MASS
MA4618559OtherAETNA
NH0300544Y0MA02OtherBLUE CROSS ANTHEM
MA1167607OtherCIGNA OF NEW ENGLAND
MA2700071OtherEVERCARE
MA31170OtherCHILDRENS MED SECURITY PLAN
MA916566OtherCOVENTRY HEALTH CCN
MA33708OtherHARVARD
MA30276OtherFALLON
714987OtherTUFTS HEALTH PLAN
T57921Medicare UPIN
MAY70671Medicare PIN