Provider Demographics
NPI:1558594192
Name:KLAMM, MARIA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:KLAMM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 W 18TH ST STE LL01
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57104-4655
Mailing Address - Country:US
Mailing Address - Phone:605-328-1859
Mailing Address - Fax:605-328-1857
Practice Address - Street 1:1210 W 18TH ST STE LL01
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57104-4655
Practice Address - Country:US
Practice Address - Phone:605-328-1859
Practice Address - Fax:605-328-1857
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-31
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD0185282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital