Provider Demographics
NPI:1184637696
Name:BOHA, KAREN E (MD)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:E
Last Name:BOHA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:207 SPARKS AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130
Mailing Address - Country:US
Mailing Address - Phone:812-218-8555
Mailing Address - Fax:812-218-8557
Practice Address - Street 1:207 SPARKS AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130
Practice Address - Country:US
Practice Address - Phone:812-218-8555
Practice Address - Fax:812-218-8557
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ININ01055459A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200363070AMedicaid
IN000000220892OtherANTHEM
IN221570CMedicare PIN
G39054Medicare UPIN