Provider Demographics
NPI:1316917545
Name:KLEIN, STEVEN R (DO)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:R
Last Name:KLEIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:23133 ORCHARD LAKE RD
Mailing Address - Street 2:STE 200
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48336-3268
Mailing Address - Country:US
Mailing Address - Phone:248-579-9220
Mailing Address - Fax:248-426-7350
Practice Address - Street 1:23133 ORCHARD LAKE RD STE 200
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336-3268
Practice Address - Country:US
Practice Address - Phone:248-579-9220
Practice Address - Fax:248-471-9978
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101008192207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3040663-11Medicaid
E31895Medicare UPIN