Provider Demographics
NPI:1508834227
Name:KLEIN, STEVEN MARTIN (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:MARTIN
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 1:28455 HAGGERTY RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48377-2982
Mailing Address - Country:US
Mailing Address - Phone:248-553-2200
Mailing Address - Fax:248-553-2201
Practice Address - Street 1:28455 HAGGERTY RD
Practice Address - Street 2:SUITE 100
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48377-2906
Practice Address - Country:US
Practice Address - Phone:248-553-2200
Practice Address - Fax:248-553-2201
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301056804207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4619362Medicaid
N91620029Medicare ID - Type Unspecified
MI4619362Medicaid