Provider Demographics
NPI:1891870309
Name:KLEIN, DAVID JAY (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:JAY
Last Name:KLEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:856 J CLYDE MORRIS BLVD
Mailing Address - Street 2:STE A
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23601-1318
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10085 WILLIAM F. BERNART CIRCLE
Practice Address - Street 2:
Practice Address - City:NASSAWADOX
Practice Address - State:VA
Practice Address - Zip Code:23413-0000
Practice Address - Country:US
Practice Address - Phone:757-414-8355
Practice Address - Fax:757-414-8016
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2014-01-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101246972207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A36412Medicare UPIN
VAP01064376Medicare PIN
VA1891870309Medicaid
VAVV5696AMedicare PIN