Organization
YUILL BLACK MD AND MICHAEL R KLETZ MD PC
Active
Other names
Black and Kletz MD PC
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHARLENE A DEVOL (BUSINESS MANAGER)
(703) 790-9675
Entity
Organization
Contact information
Practice address
1420 SPRING HILL RD, SUITE 350, MCLEAN, VA 22102-3006
(703) 790-9722
(703) 893-8666
Mailing address
1420 SPRING HILL RD, SUITE 350, MCLEAN, VA 22102-3006
(703) 790-9722
(703) 893-8666
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CD8485
RAILROAD MEDICARE PIN
VA
Enumeration date
07/13/2006
Last updated
10/31/2007
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