Provider Demographics
NPI:1437152758
Name:HAWVER, KARL DEREK (MD)
Entity Type:Individual
Prefix:DR
First Name:KARL
Middle Name:DEREK
Last Name:HAWVER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4213 SAUL RD
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-3728
Mailing Address - Country:US
Mailing Address - Phone:301-933-8321
Mailing Address - Fax:301-933-5075
Practice Address - Street 1:4213 SAUL RD
Practice Address - Street 2:
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-3728
Practice Address - Country:US
Practice Address - Phone:301-933-8321
Practice Address - Fax:301-933-5075
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00050162084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
HA174421Medicare ID - Type Unspecified
C88257Medicare UPIN