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Individual

DR. RONALD ELLIS KLEINMAN

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
55 FRUIT ST, YAW 6, BOSTON, MA 02114-2621
(617) 726-1450
(617) 724-2710
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 724-0287
(617) 726-2894

Taxonomy

Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
41023
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0110043
MA
01
702613
TUFTS HEALTH PLAN
MA
01
E05243
BCBS MA
MA
Enumeration date
11/02/2005
Last updated
07/08/2007
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