Provider Demographics
NPI:1063473791
Name:ROANE, KAREN D (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:D
Last Name:ROANE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:401 KEISLER DR
Mailing Address - Street 2:STE 101
Mailing Address - City:GARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511
Mailing Address - Country:US
Mailing Address - Phone:919-233-8885
Mailing Address - Fax:919-233-0889
Practice Address - Street 1:401 KEISLER DR
Practice Address - Street 2:STE 101
Practice Address - City:GARY
Practice Address - State:NC
Practice Address - Zip Code:27511
Practice Address - Country:US
Practice Address - Phone:919-233-8885
Practice Address - Fax:919-233-0889
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC33122207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F50275Medicare UPIN
2314400Medicare ID - Type Unspecified