Provider Demographics
NPI:1225169709
Name:FERGUSON, KAREN LOUISE (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:LOUISE
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3755 7TH TERRACE
Mailing Address - Street 2:SUITE 302A
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-6557
Mailing Address - Country:US
Mailing Address - Phone:772-299-0721
Mailing Address - Fax:772-299-0723
Practice Address - Street 1:3755 7TH TERRACE
Practice Address - Street 2:SUITE 302A
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-6557
Practice Address - Country:US
Practice Address - Phone:772-299-0721
Practice Address - Fax:772-299-0723
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME37491207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD54625Medicare UPIN
FL37436AMedicare PIN