Provider Demographics
NPI:1942399738
Name:KLEIN, GARY MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:MICHAEL
Last Name:KLEIN
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 1:8035 PROVIDENCE RD STE 315
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-8909
Mailing Address - Country:US
Mailing Address - Phone:704-444-0999
Mailing Address - Fax:877-613-9166
Practice Address - Street 1:8035 PROVIDENCE RD STE 315
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-8909
Practice Address - Country:US
Practice Address - Phone:704-444-0999
Practice Address - Fax:877-613-9166
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200101081207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine