Provider Demographics
NPI:1174665152
Name:CASH, KAREN (OD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:
Last Name:CASH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2167 N PONTIAC TRL
Mailing Address - Street 2:
Mailing Address - City:COMMERCE TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48390-3162
Mailing Address - Country:US
Mailing Address - Phone:248-851-1125
Mailing Address - Fax:248-960-2202
Practice Address - Street 1:2167 N PONTIAC TRL
Practice Address - Street 2:
Practice Address - City:COMMERCE TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48390-3162
Practice Address - Country:US
Practice Address - Phone:248-960-2200
Practice Address - Fax:248-960-2202
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901003313152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1841453826Medicaid
MIU89506Medicare UPIN