Provider Demographics
NPI:1194250704
Name:KLEIN, KLARA (MD/PHD)
Entity type:Individual
Prefix:
First Name:KLARA
Middle Name:
Last Name:KLEIN
Suffix:
Gender:F
Credentials:MD/PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:AMBULATORY CARE CTR
Mailing Address - Street 2:102 MASON FARM RD
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-6134
Mailing Address - Country:US
Mailing Address - Phone:919-966-1459
Mailing Address - Fax:919-843-2356
Practice Address - Street 1:AMBULATORY CARE CTR
Practice Address - Street 2:102 MASON FARM RD
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-6134
Practice Address - Country:US
Practice Address - Phone:919-966-1459
Practice Address - Fax:919-843-2356
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-21
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC227232390200000X
NC2019-00931207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program