Provider Demographics
NPI:1245228865
Name:BRETZ, KAREN A (MD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:A
Last Name:BRETZ
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 1:4905 W TILGHMAN ST
Mailing Address - Street 2:SUITE 250
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-9130
Mailing Address - Country:US
Mailing Address - Phone:484-866-9583
Mailing Address - Fax:610-366-1147
Practice Address - Street 1:4905 W TILGHMAN ST
Practice Address - Street 2:SUITE 250
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-9130
Practice Address - Country:US
Practice Address - Phone:484-866-9583
Practice Address - Fax:610-366-1147
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD023140E207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0486095OtherKHP CENTRAL
PA01062456OtherGATEWAY
PA1004236OtherAMERIHEALTH MERCY
PA1004236OtherKEYSTONE MERCY
PA000000093962OtherTHREE RIVERS
PA0010624560001Medicaid
PA0040579000OtherINDEP. BLUE CROSS
PA486095OtherHIGHMARK
PA0040579000OtherINDEP. BLUE CROSS
PA0010624560001Medicaid
PA486095EU8Medicare PIN