Provider Demographics
NPI:1942288352
Name:KLIMKOWSKI, PAUL EDWARD (PAC)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:EDWARD
Last Name:KLIMKOWSKI
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 WILSON BLVD
Mailing Address - Street 2:827
Mailing Address - City:ROSSLYN
Mailing Address - State:VA
Mailing Address - Zip Code:22209-2460
Mailing Address - Country:US
Mailing Address - Phone:571-533-5995
Mailing Address - Fax:
Practice Address - Street 1:1501 WILSON BLVD
Practice Address - Street 2:827
Practice Address - City:ROSSLYN
Practice Address - State:VA
Practice Address - Zip Code:22209-2460
Practice Address - Country:US
Practice Address - Phone:571-533-5995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-05
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical