Provider Demographics
NPI:1942216163
Name:KLAUBER, GEORGE THOMAS (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:THOMAS
Last Name:KLAUBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 FAYETTE STREET
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-5518
Mailing Address - Country:US
Mailing Address - Phone:617-482-3032
Mailing Address - Fax:
Practice Address - Street 1:800 WASHINGTON ST # 92
Practice Address - Street 2:TUFTS MEDICAL CENTER
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111-1552
Practice Address - Country:US
Practice Address - Phone:617-636-5360
Practice Address - Fax:617-636-4267
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMA44892208000000X, 208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
B20065201OtherCIGNA
0012642OtherNEIGHBORHOOD HEALTH PLAN
GK07768OtherRI MEDICAID
MA007129OtherTUFTS MEDICAL CENTER
0106267OtherMASS HEALTH
27834NEMCOtherHARVARD PILGRIM
0106267OtherMA MEDICAID
MA0106267Medicaid
1900088OtherUNITED HEALTH CARE
MA044892OtherTUFTS HEALTH PLAN
992571OtherNETWORK HEALTH
E05074OtherBLUE SHIELD INDEMNITY
E05074OtherBLUE SHIELD MANAGED CARE
27357OtherPILGRIM
0509748OtherAETNA US HEALTHCARE
1900088OtherUNITED HEALTH CARE
A54274Medicare UPIN