Basic Information
| Provider Information | |||||||||
| NPI: | 1316976640 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KLEINMAN | ||||||||
| FirstName: | MICHAEL | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1803 MOUNT ROSE AVE | ||||||||
| Address2: | STE B3 | ||||||||
| City: | YORK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 174033026 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7178511405 | ||||||||
| FaxNumber: | 7178516969 | ||||||||
| Practice Location | |||||||||
| Address1: | 1001 S GEORGE ST | ||||||||
| Address2: | YORK HOSPITAL EMERGENCY DEPARTMENT | ||||||||
| City: | YORK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 174033676 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7178512450 | ||||||||
| FaxNumber: | 7178513469 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2006 | ||||||||
| LastUpdateDate: | 04/04/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | OS004436L | PA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 39622 | 01 | PA | GEISINGER-YH | OTHER | 50067229 | 01 | PA | CAPITAL BLUE CROSS-YH | OTHER | 000657768 | 05 | PA | MEDICAID | 1141119 | 01 | PA | AMERIHEALTH MERCY-YH | OTHER | 0068851000 | 01 | PA | AMERIHEALTH 65 PA | OTHER | 1537584 | 01 | PA | GATEWAY-YH | OTHER | 152887 | 01 | PA | HIGHMARK BLUE SHIELD-YH | OTHER |