Provider Demographics
NPI:1609877463
Name:KLEIN, ALAN H (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:H
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 1:22201 MOROSS RD STE 150
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48236-2152
Mailing Address - Country:US
Mailing Address - Phone:313-343-7110
Mailing Address - Fax:313-343-7081
Practice Address - Street 1:22201 MOROSS RD STE 150
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48236-2152
Practice Address - Country:US
Practice Address - Phone:313-343-7110
Practice Address - Fax:313-343-7081
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD042946L207X00000X
MI4301500979207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0777842Medicaid
WV0097851000Medicaid
PA1012706300002Medicaid
PA742429NH3Medicare PIN
PAF55379Medicare UPIN
PA1012706300002Medicaid