Provider Demographics
NPI:1629045166
Name:KLAPPER, MITCHELL (MD)
Entity Type:Individual
Prefix:
First Name:MITCHELL
Middle Name:
Last Name:KLAPPER
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 1:122 SLADE AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-4915
Mailing Address - Country:US
Mailing Address - Phone:410-486-1177
Mailing Address - Fax:410-486-4271
Practice Address - Street 1:122 SLADE AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-4915
Practice Address - Country:US
Practice Address - Phone:410-486-1177
Practice Address - Fax:410-486-4271
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD34834174400000X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD478308OtherAETNA
MD438231500Medicaid
MD212599OtherMAMSI
MD438231500Medicaid
MD4680Medicare ID - Type Unspecified