Provider Demographics
NPI:1417445636
Name:KLAUS, SUZANNE MICHELLE (MD, PHD)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:MICHELLE
Last Name:KLAUS
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:SUZANNE
Other - Middle Name:MICHELLE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:22 S GREENE ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-1590
Mailing Address - Country:US
Mailing Address - Phone:410-328-9878
Mailing Address - Fax:410-328-6382
Practice Address - Street 1:22 S GREENE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1590
Practice Address - Country:US
Practice Address - Phone:410-328-9878
Practice Address - Fax:410-328-6382
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-24
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZR76671208600000X
MDD0099379208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD0099379OtherMARYLAND BOARD OF PHYSICIANS