Provider Demographics
NPI:1962492124
Name:KLEINMAN, STEPHEN CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:CHARLES
Last Name:KLEINMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-724-8200
Mailing Address - Fax:617-726-3514
Practice Address - Street 1:73 HIGH ST
Practice Address - Street 2:CTN CHARLESTOWN HEALTHCARE CENTER
Practice Address - City:CHARLESTOWN
Practice Address - State:MA
Practice Address - Zip Code:02129-3026
Practice Address - Country:US
Practice Address - Phone:617-724-8200
Practice Address - Fax:617-726-3514
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2012-11-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA374452084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA6184375Medicaid
MA037445OtherTUFTS HEALTH PLAN
MA037445OtherTUFTS HEALTH PLAN
MA6184375Medicaid