Provider Demographics
NPI:1871240838
Name:KLUKO, MATTHEW J (MD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:J
Last Name:KLUKO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 W SIDE DR APT 204
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-3045
Mailing Address - Country:US
Mailing Address - Phone:516-617-2170
Mailing Address - Fax:
Practice Address - Street 1:9318 GAITHER RD STE 220
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-1409
Practice Address - Country:US
Practice Address - Phone:301-251-4702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-09
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch