Basic Information
Provider Information
NPI: 1023472214
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KLINEDINST
FirstName: HEATHER
MiddleName: MAY
NamePrefix: DR.
NameSuffix:  
Credential: MD, MPH
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: STODDARD
OtherFirstName: HEATHER
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 110 IRVING ST NW
Address2: DEPT OF SURGERY
City: WASHINGTON
State: DC
PostalCode: 200103017
CountryCode: US
TelephoneNumber: 2028773536
FaxNumber: 2028773699
Practice Location
Address1: 112 N 7TH ST
Address2:  
City: CHAMBERSBURG
State: PA
PostalCode: 172011720
CountryCode: US
TelephoneNumber: 7172677164
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/13/2016
LastUpdateDate: 07/28/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/28/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
207L00000XMD471594PAY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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