Provider Demographics
NPI:1962464859
Name:KLEIN, DEBORAH K (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:K
Last Name:KLEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:DEBORAH
Other - Middle Name:K
Other - Last Name:MAGUE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2800 HENNEPIN AV
Mailing Address - Street 2:
Mailing Address - City:MPLS
Mailing Address - State:MN
Mailing Address - Zip Code:55419
Mailing Address - Country:US
Mailing Address - Phone:612-775-4800
Mailing Address - Fax:612-775-4801
Practice Address - Street 1:2800 HENNEPIN AV
Practice Address - Street 2:
Practice Address - City:MPLS
Practice Address - State:MN
Practice Address - Zip Code:55419
Practice Address - Country:US
Practice Address - Phone:612-775-4800
Practice Address - Fax:612-775-4801
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN45257207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN110014374Medicare UPIN