Provider Demographics
NPI:1801865639
Name:FEHR-D'ALESSANDRO, KAREN LOUISE (MD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:LOUISE
Last Name:FEHR-D'ALESSANDRO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5354 REYNOLDS ST
Mailing Address - Street 2:SUITE 222
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-6007
Mailing Address - Country:US
Mailing Address - Phone:912-692-1080
Mailing Address - Fax:912-691-0551
Practice Address - Street 1:5354 REYNOLDS ST
Practice Address - Street 2:SUITE 222
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-6007
Practice Address - Country:US
Practice Address - Phone:912-692-1080
Practice Address - Fax:912-691-0551
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA035178174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP6159Medicare PIN
F88634Medicare UPIN
GA16BDTPSMedicare Oscar/Certification