Provider Demographics
NPI:1245222074
Name:ACEVEDO-MOGHARBEL, KAREN MARIE (DO)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:MARIE
Last Name:ACEVEDO-MOGHARBEL
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:3035 S ELLSWORTH RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85212-2160
Mailing Address - Country:US
Mailing Address - Phone:480-736-1777
Mailing Address - Fax:480-736-1144
Practice Address - Street 1:3035 S ELLSWORTH RD
Practice Address - Street 2:SUITE 103
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85212
Practice Address - Country:US
Practice Address - Phone:480-736-1777
Practice Address - Fax:480-736-1144
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2009-03-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ3882207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ7677424OtherAETNA
AZ1Z9851OtherHEALTH NET
AZAZ0743320OtherBCBS
AZ819815Medicaid
AZ2284444OtherUNITED HEALTHCARE
AZ1Z9851OtherHEALTH NET
AZ2284444OtherUNITED HEALTHCARE