Provider Demographics
NPI:1083615058
Name:KAARIAINEN, ISMO MIKAEL (MD)
Entity Type:Individual
Prefix:
First Name:ISMO
Middle Name:MIKAEL
Last Name:KAARIAINEN
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 1:400 SHADOWLINE DR STE 203
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-5022
Mailing Address - Country:US
Mailing Address - Phone:828-263-8707
Mailing Address - Fax:828-263-8710
Practice Address - Street 1:400 SHADOWLINE DR STE 203
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-5022
Practice Address - Country:US
Practice Address - Phone:828-263-8707
Practice Address - Fax:828-263-8710
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200101075174400000X, 207R00000X, 208M00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No174400000XOther Service ProvidersSpecialist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
14262OtherNCBC
NC89129PFMedicaid
NC129PFOtherBCBS - CVMC
14262OtherNCBC
G56303Medicare UPIN
NC89129PFMedicare ID - Type Unspecified
NC2290173Medicare ID - Type Unspecified