Provider Demographics
NPI:1609877463
Name:KLEIN, ALAN H (MD)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:H
Last Name:KLEIN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 FORD PL STE 3A
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202-3450
Mailing Address - Country:US
Mailing Address - Phone:138-744-8063
Mailing Address - Fax:
Practice Address - Street 1:30795 23 MILE RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MI
Practice Address - Zip Code:48047-5720
Practice Address - Country:US
Practice Address - Phone:586-228-6200
Practice Address - Fax:586-228-6201
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD042946L207X00000X
MI4301500979207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0777842Medicaid
WV0097851000Medicaid
PA1012706300002Medicaid
PA742429NH3Medicare PIN
PAF55379Medicare UPIN
PA1012706300002Medicaid