Provider Demographics
NPI:1124032271
Name:KARSHBAUM, STEPHEN HOWARD (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:HOWARD
Last Name:KARSHBAUM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:800 W CUMMINGS PARK
Mailing Address - Street 2:SUITE 6475
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-6372
Mailing Address - Country:US
Mailing Address - Phone:781-569-6541
Mailing Address - Fax:781-569-6557
Practice Address - Street 1:1 ORTHOPEDIC DR
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-1668
Practice Address - Country:US
Practice Address - Phone:978-818-6272
Practice Address - Fax:978-818-6282
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA787112085R0202X
RIMD110642085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAA30173Medicare ID - Type Unspecified
MAH03539Medicare UPIN