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Individual

DR. MICHAEL R KLETZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1420 SPRING HILL RD, SUITE 350, MCLEAN, VA 22102-3006
(703) 790-9722
Mailing address
1420 SPRING HILL RD STE 350, MC LEAN, VA 22102-3040
(703) 790-9722
(703) 893-8666

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101043722
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
030002414
RAILROAD MEDICARE
05
6023312
VA
Enumeration date
07/18/2006
Last updated
05/29/2008
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