Provider Demographics
NPI:1306081641
Name:KLERIS, RENEE GEORGIA STEPHANIE (MD)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:GEORGIA STEPHANIE
Last Name:KLERIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 RESEARCH DR
Mailing Address - Street 2:DUMC BOX 2644, 101 MSRB1
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27710-3022
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:203 RESEARCH DR
Practice Address - Street 2:DUMC BOX 2644, 101 MSRB1
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-3022
Practice Address - Country:US
Practice Address - Phone:919-684-8657
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-15
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
RILP02642208000000X
NC2015-010902080P0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No208000000XAllopathic & Osteopathic PhysiciansPediatrics