Provider Demographics
NPI:1326074360
Name:STANLAW, KAREN A (MD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:A
Last Name:STANLAW
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 1:86-260 FARRINGTON HWY
Mailing Address - Street 2:WAIANAE COAST COMPREHENSIVE HEALTH CENTER
Mailing Address - City:WAIANAE
Mailing Address - State:HI
Mailing Address - Zip Code:96792
Mailing Address - Country:US
Mailing Address - Phone:920-265-6902
Mailing Address - Fax:
Practice Address - Street 1:86-260 FARRINGTON HWY
Practice Address - Street 2:WAIANAE COAST COMPREHENSIVE HEALTH CENTER
Practice Address - City:WAIANAE
Practice Address - State:HI
Practice Address - Zip Code:96792
Practice Address - Country:US
Practice Address - Phone:920-265-6902
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI31178-020207P00000X
HIMD -10540207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI31636600Medicaid
MI104288395Medicaid
WI930101346OtherMEDICARE RAILROAD
WI930101348OtherMEDICARE RAILROAD
WI930101348OtherMEDICARE RAILROAD
WI0043-07660Medicare ID - Type Unspecified
WI31636600Medicaid
WI0030-40115Medicare ID - Type Unspecified