Provider Demographics
NPI:1326205618
Name:RADUAZO, KAREN ANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:ANNE
Last Name:RADUAZO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:KAREN
Other - Middle Name:ANNE
Other - Last Name:SCHINKEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 118008
Mailing Address - Street 2:
Mailing Address - City:N CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29423-8008
Mailing Address - Country:US
Mailing Address - Phone:843-569-1856
Mailing Address - Fax:843-569-1879
Practice Address - Street 1:9313 MEDICAL PLAZA DR
Practice Address - Street 2:STE 310
Practice Address - City:N CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-9155
Practice Address - Country:US
Practice Address - Phone:843-569-1856
Practice Address - Fax:846-569-1879
Is Sole Proprietor?:No
Enumeration Date:2008-05-22
Last Update Date:2014-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC344452084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC344452Medicaid
SCP01280476OtherRAIL ROAD MEDICARE
SC344452Medicaid