Kloss, David A

Kloss, David A is an individual health care provider with primary practice located at 100 County Road B , Shawano WI 54166-7072. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Other Service Providers / Specialist. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Kloss, David A can be contacted via phone (715) 524-2161.

Contact Information

Primary practice address
100 County Road B Shawano WI 54166-7072
Phone: (715) 524-2161
Fax: (715) 524-8164
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 68403 Wisconsin
Other Service Providers / Specialist 174400000X 033503 Connecticut
Allopathic & Osteopathic Physicians / Surgery 208600000X 54709 Minnesota

Profile Details

NPI number 1003842915
LBN Legal business name Kloss, David A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2006
Last updated Jun 5th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003842915 NPPES
Connecticut Other 010033503CT01 ANTHEM BC / BS
Connecticut MEDICAID 001335034 ANTHEM BC / BS
Connecticut Other 0706347 ANTHEM BC / BS
Connecticut Other 001335034 ANTHEM BC / BS
Connecticut Other 335030 ANTHEM BC / BS
Connecticut Other 1144213006 ANTHEM BC / BS
Connecticut Other WIS020 ANTHEM BC / BS
Connecticut Other 030515 ANTHEM BC / BS
Connecticut Other P02113 ANTHEM BC / BS

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