Provider Demographics
NPI:1619986114
Name:MITCHELL, KAREN C (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:C
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:340 MAPLE ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:MARLBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01752-3200
Mailing Address - Country:US
Mailing Address - Phone:508-485-7779
Mailing Address - Fax:508-485-7769
Practice Address - Street 1:340 MAPLE ST
Practice Address - Street 2:SUITE 203
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-3200
Practice Address - Country:US
Practice Address - Phone:508-485-7779
Practice Address - Fax:508-485-7769
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2015-01-08
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Provider Licenses
StateLicense IDTaxonomies
MA208889207ND0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110062526AMedicaid
MAA3300703Medicare PIN
MA110062526AMedicaid