Provider Demographics
NPI:1841410412
Name:KAREN H. HARUM, MD, FAAP, PLLC
Entity Type:Organization
Organization Name:KAREN H. HARUM, MD, FAAP, PLLC
Other - Org Name:DBA CLINIC FOR SPECIAL CHILDREN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:HORTON
Authorized Official - Last Name:HARUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-319-7744
Mailing Address - Street 1:432 EASTWOOD RD
Mailing Address - Street 2:#200
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403
Mailing Address - Country:US
Mailing Address - Phone:910-319-7744
Mailing Address - Fax:910-319-7754
Practice Address - Street 1:432 EASTWOOD RD
Practice Address - Street 2:#200
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403
Practice Address - Country:US
Practice Address - Phone:910-319-7744
Practice Address - Fax:910-319-7754
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC34344208000000X, 2080P0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0008XAllopathic & Osteopathic PhysiciansPediatricsNeurodevelopmental DisabilitiesGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89013MTMedicaid
NC013MTOtherBCBS