Provider Demographics
NPI:1790870483
Name:KLEIN, STUART M (MD)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:M
Last Name:KLEIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9696 GORDON DR
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:IN
Mailing Address - Zip Code:46322-2909
Mailing Address - Country:US
Mailing Address - Phone:219-937-2511
Mailing Address - Fax:219-937-2522
Practice Address - Street 1:9696 GORDON DR
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:IN
Practice Address - Zip Code:46322-2909
Practice Address - Country:US
Practice Address - Phone:219-937-2511
Practice Address - Fax:219-937-2522
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2021-03-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01031791A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E05547Medicare UPIN