Provider Demographics
NPI:1376507343
Name:SICKENGER, KAREN ELIZABETH (MD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:ELIZABETH
Last Name:SICKENGER
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 1:816 INDEPENDENCE BLVD
Mailing Address - Street 2:STE 2G
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-6010
Mailing Address - Country:US
Mailing Address - Phone:757-363-6230
Mailing Address - Fax:757-363-6204
Practice Address - Street 1:816 INDEPENDENCE BLVD
Practice Address - Street 2:STE 2G
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-6010
Practice Address - Country:US
Practice Address - Phone:757-363-6230
Practice Address - Fax:757-363-6204
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101056602207L00000X
NC200501351207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC182810OtherMEDCOST CHS, NC
NC140PJOtherBCBS NC CHS, NC
NC4874249OtherCIGNA CHS,NC
NC5901770Medicaid
NC806387OtherPARTNERS CHS, NC
NCP00282904OtherRAILROAD-MEDICARE CHS,NC
NC140PJOtherBCBS NC CHS, NC
NC4874249OtherCIGNA CHS,NC