Provider Demographics
NPI:1437484524
Name:KLEIN, ERAN (MD/PHD)
Entity Type:Individual
Prefix:
First Name:ERAN
Middle Name:
Last Name:KLEIN
Suffix:
Gender:M
Credentials:MD/PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6345 GRAY SEA WAY
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-7405
Mailing Address - Country:US
Mailing Address - Phone:503-419-7291
Mailing Address - Fax:
Practice Address - Street 1:6345 GRAY SEA WAY
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-7405
Practice Address - Country:US
Practice Address - Phone:503-419-7291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-07
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00682802084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD028794600Medicaid
MD172538YVAMedicare PIN