Provider Demographics
NPI:1356464770
Name:MCFARLANE, KAREN NICHOLE (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:NICHOLE
Last Name:MCFARLANE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1221 RICHARDSON ST
Mailing Address - Street 2:
Mailing Address - City:PORT HURON
Mailing Address - State:MI
Mailing Address - Zip Code:48060-3548
Mailing Address - Country:US
Mailing Address - Phone:810-662-0400
Mailing Address - Fax:810-824-3576
Practice Address - Street 1:1221 RICHARDSON ST
Practice Address - Street 2:
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-3548
Practice Address - Country:US
Practice Address - Phone:810-662-0400
Practice Address - Fax:810-824-3576
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH147392086S0122X
MN52301208600000X
MI4301084126208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1356464770Medicaid
MI1356464770Medicaid