Provider Demographics
NPI:1205026994
Name:FAGIN, KAREN A (MD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:A
Last Name:FAGIN
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:PO BOX 673671
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48267-3671
Mailing Address - Country:US
Mailing Address - Phone:810-720-5715
Mailing Address - Fax:810-732-0891
Practice Address - Street 1:4201 SAINT ANTOINE ST
Practice Address - Street 2:UHC, SUITE 6A
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2153
Practice Address - Country:US
Practice Address - Phone:313-745-4230
Practice Address - Fax:313-745-4298
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-28
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG44672207T00000X
GA47757207T00000X
MI4301086008207T00000X
MT101037207T00000X
NE23004207T00000X
ND8300207T00000X
ORMD19638207T00000X
PAMD035158E207T00000X
WA00038053207T00000X
WY6911A207T00000X
ME015316207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery