Provider Demographics
NPI:1578739777
Name:ALAN J KLEIMAN DPM PA
Entity Type:Organization
Organization Name:ALAN J KLEIMAN DPM PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:KLEIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:410-467-4445
Mailing Address - Street 1:839 WEST 36TH STREET
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21211-2508
Mailing Address - Country:US
Mailing Address - Phone:410-467-4445
Mailing Address - Fax:410-467-4446
Practice Address - Street 1:839 WEST 36TH STREET
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21211-2508
Practice Address - Country:US
Practice Address - Phone:410-467-4445
Practice Address - Fax:410-467-4446
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALAN J KLEIMAN DPM PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-07
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00512213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0786940001Medicare NSC