# JOHN PETER KLIM

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1508834672
- **Gender:** Man
- **Credential:** DO

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | 02002790A | IN | — |
| 207LA0401X | Addiction Medicine (Anesthesiology) Physician | 02002790A | IN | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | 02002790A | IN | Yes |

## Other

- **Enumeration date:** 03/14/2006
- **Last updated:** 02/15/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000712623 | ANTHEM | IN |
| 01 | — | 11492492 | CAQH | IN |
| 05 | — | 200462270 | — | IN |