Basic Information
| Provider Information | |||||||||
| NPI: | 1780145169 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KLINE | ||||||||
| FirstName: | EMILY | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 220 CAMPUS BLVD STE 100 | ||||||||
| Address2: | |||||||||
| City: | WINCHESTER | ||||||||
| State: | VA | ||||||||
| PostalCode: | 226012896 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5405365100 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3790 HEDGESVILLE RD STE H | ||||||||
| Address2: | |||||||||
| City: | HEDGESVILLE | ||||||||
| State: | WV | ||||||||
| PostalCode: | 254276704 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3047547160 | ||||||||
| FaxNumber: | 3047547244 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/27/2019 | ||||||||
| LastUpdateDate: | 08/12/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/12/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | WV | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207Q00000X | 31575 | WV | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.