Provider Demographics
NPI:1780646935
Name:KLEIMAN, BRUCE J (MD)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:J
Last Name:KLEIMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:208 E. PLUME STREET
Mailing Address - Street 2:SUITE 213
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23510
Mailing Address - Country:US
Mailing Address - Phone:757-685-6157
Mailing Address - Fax:757-961-8385
Practice Address - Street 1:208 E. PLUME STREET
Practice Address - Street 2:SUITE 213
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23510
Practice Address - Country:US
Practice Address - Phone:757-685-6157
Practice Address - Fax:757-961-8385
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101239530207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1043524333OtherGROUP NPI
VA1043524333OtherGROUP NPI
VAVAA102855Medicare PIN