Provider Demographics
NPI:1760455091
Name:KLEIN, DONALD E (MD)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:E
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 1:95 PITMAN ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-4311
Mailing Address - Country:US
Mailing Address - Phone:401-421-1232
Mailing Address - Fax:401-421-7990
Practice Address - Street 1:95 PITMAN ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-4311
Practice Address - Country:US
Practice Address - Phone:401-421-1232
Practice Address - Fax:401-421-7990
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD04192207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
28862OtherBLUE CROSS
59688OtherCIGNA
300137OtherBLUE CHP
RIDK30377Medicaid
02000282OtherUNITED HEALTH
4277OtherNEIGHBORHOOD HEALTH PLAN
C90271Medicare UPIN