Provider Demographics
NPI:1639102494
Name:CORVIN, KAREN WIERWILLE (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:WIERWILLE
Last Name:CORVIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:11001 DURANT RD
Mailing Address - Street 2:100
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27614-8390
Mailing Address - Country:US
Mailing Address - Phone:919-781-2500
Mailing Address - Fax:919-781-9247
Practice Address - Street 1:11001 DURANT RD STE 100
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27614
Practice Address - Country:US
Practice Address - Phone:919-781-2500
Practice Address - Fax:919-781-9247
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9601274207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8924413Medicaid
NCG34029Medicare UPIN