Provider Demographics
NPI:1669975470
Name:KLETZ, NED (MD)
Entity type:Individual
Prefix:
First Name:NED
Middle Name:
Last Name:KLETZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1450 W LONG LAKE RD STE 340
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48098-6330
Mailing Address - Country:US
Mailing Address - Phone:248-905-5091
Mailing Address - Fax:248-905-5096
Practice Address - Street 1:1287 FULTON RD
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95401-4923
Practice Address - Country:US
Practice Address - Phone:707-800-7700
Practice Address - Fax:707-800-7797
Is Sole Proprietor?:No
Enumeration Date:2018-03-18
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA1770892084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry