Provider Demographics
NPI:1184621690
Name:KLEINMAN, CAROL COLE (MD)
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:COLE
Last Name:KLEINMAN
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 1:5480 WISCONSIN AVE
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-3533
Mailing Address - Country:US
Mailing Address - Phone:301-654-1810
Mailing Address - Fax:301-656-2137
Practice Address - Street 1:5480 WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-3530
Practice Address - Country:US
Practice Address - Phone:301-654-1810
Practice Address - Fax:301-656-2137
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD26772174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD23208OtherMAMSI
MDB94421Medicare UPIN
MDKL198624Medicare ID - Type Unspecified