Provider Demographics
NPI:1740587435
Name:PAVEL KLEIN
Entity Type:Organization
Organization Name:PAVEL KLEIN
Other - Org Name:MID-ATLANTIC EPILEPSY & SLEEP CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAVEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-530-9744
Mailing Address - Street 1:6410 ROCKLEDGE DR
Mailing Address - Street 2:SUITE 610
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-1809
Mailing Address - Country:US
Mailing Address - Phone:301-530-9744
Mailing Address - Fax:301-530-0046
Practice Address - Street 1:6410 ROCKLEDGE DR
Practice Address - Street 2:SUITE 410
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-1809
Practice Address - Country:US
Practice Address - Phone:301-530-9744
Practice Address - Fax:301-530-0046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-16
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00542702084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty