Provider Demographics
NPI:1174612246
Name:KLEIN, MARK STEVEN (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:STEVEN
Last Name:KLEIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7501 SURRAITS RD
Mailing Address - Street 2:#204
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735
Mailing Address - Country:US
Mailing Address - Phone:301-856-2556
Mailing Address - Fax:301-856-8956
Practice Address - Street 1:7501 SURRAITS RD
Practice Address - Street 2:#204
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735
Practice Address - Country:US
Practice Address - Phone:301-856-2556
Practice Address - Fax:301-856-8956
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-11-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MD017032207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD183079Medicare PIN
MDC62405Medicare UPIN