Provider Demographics
NPI:1518173558
Name:KARIM, AFSHEEN ABDUL (MD)
Entity Type:Individual
Prefix:
First Name:AFSHEEN
Middle Name:ABDUL
Last Name:KARIM
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 1:2145 NOLL DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-7600
Mailing Address - Country:US
Mailing Address - Phone:717-397-4921
Mailing Address - Fax:717-397-7170
Practice Address - Street 1:2145 NOLL DIRVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-7600
Practice Address - Country:US
Practice Address - Phone:717-397-4921
Practice Address - Fax:717-397-7170
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036122216207Q00000X
IL125051391390200000X
PAMD439987207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP00758138/CK6882OtherRAIL ROAD MEDICARE
IL050540914OtherWGHP TAX ID
IL036122216Medicaid
ILP00758138/CK6882OtherRAIL ROAD MEDICARE
IL036122216Medicaid
26-2511919OtherTIN