Provider Demographics
NPI:1487638177
Name:KLUGER, PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:
Last Name:KLUGER
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 1:43 WHITING HILL RD
Mailing Address - Street 2:
Mailing Address - City:BREWER
Mailing Address - State:ME
Mailing Address - Zip Code:04412-1005
Mailing Address - Country:US
Mailing Address - Phone:207-973-5000
Mailing Address - Fax:207-973-5042
Practice Address - Street 1:885 UNION ST
Practice Address - Street 2:SUITE 145
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-3083
Practice Address - Country:US
Practice Address - Phone:207-973-9595
Practice Address - Fax:207-973-7898
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-06
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME012600207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME002412OtherANTHEM BLUE SHIELD
ME1040656OtherAETNA INDIV #
ME620012901OtherCIGNA INDIV #
ME306530099Medicaid
ME040013980OtherRAILROAD INDIV PROV #
ME110570001Medicaid
ME100224700OtherDEPT OF LABOR GROUP #
ME110570000Medicaid
ME002412OtherANTHEM BLUE SHIELD
ME620012901OtherCIGNA INDIV #
ME040013980OtherRAILROAD INDIV PROV #
ME110570001Medicaid