Provider Demographics
NPI:1407803182
Name:KARO, KATHERINE (DO)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:KARO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50581 LANGLEY DR
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48374-2528
Mailing Address - Country:US
Mailing Address - Phone:248-535-8555
Mailing Address - Fax:248-535-8555
Practice Address - Street 1:50581 LANGLEY DR
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48374-2528
Practice Address - Country:US
Practice Address - Phone:248-535-8555
Practice Address - Fax:248-535-8555
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-28
Last Update Date:2013-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIKK013414208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5101013414OtherCDS
MI11280027OtherCAQH
MI114707438Medicaid
MI5101013414OtherSTATE LICENSE #
MI5822408OtherTYPE 1 BCBS PIN
MI11280027OtherCAQH
MI5101013414OtherSTATE LICENSE #
MI114707438Medicaid