Provider Demographics
NPI:1508868241
Name:KLINE, LEWIS R (MD)
Entity Type:Individual
Prefix:
First Name:LEWIS
Middle Name:R
Last Name:KLINE
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 1:4815 LIBERTY AVE STE 250
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-2156
Mailing Address - Country:US
Mailing Address - Phone:724-671-1002
Mailing Address - Fax:724-671-1003
Practice Address - Street 1:4815 LIBERTY AVE STE 250
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-2156
Practice Address - Country:US
Practice Address - Phone:724-671-1002
Practice Address - Fax:724-671-1003
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-025832-E207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0008756780005Medicaid
WV0073202000Medicaid
PA0008756780003Medicaid
PA110044196OtherRAILROAD MEDICARE
PAC31298Medicare UPIN
PA0008756780003Medicaid
PA0008756780005Medicaid
PAP00218668Medicare PIN
PA110044196OtherRAILROAD MEDICARE