Provider Demographics
NPI:1881698488
Name:KLAIMAN, MARK D (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:D
Last Name:KLAIMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3206 ELLICOTT ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008-2059
Mailing Address - Country:US
Mailing Address - Phone:202-244-5484
Mailing Address - Fax:
Practice Address - Street 1:6400 GOLDSBORO RD STE 340
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-5824
Practice Address - Country:US
Practice Address - Phone:301-493-8884
Practice Address - Fax:301-493-0200
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMD31062174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA216311000Medicaid
F91135Medicare UPIN
00B337M71Medicare ID - Type Unspecified