Provider Demographics
NPI:1790783413
Name:ULLIAN, KAREN MENZER (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:MENZER
Last Name:ULLIAN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2861 TRICOM ST
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-9172
Mailing Address - Country:US
Mailing Address - Phone:843-725-0064
Mailing Address - Fax:843-569-7885
Practice Address - Street 1:1548 ASHLEY RIVER RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-5296
Practice Address - Country:US
Practice Address - Phone:843-556-0218
Practice Address - Fax:843-571-6431
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2019-08-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SC14332207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC143321Medicaid
SCE193903244Medicare ID - Type Unspecified
SCE19390Medicare UPIN