Provider Demographics
NPI:1881669026
Name:MOFFETT, KAREN E (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:E
Last Name:MOFFETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:830 CHESAPEAKE DR
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21613-9408
Mailing Address - Country:US
Mailing Address - Phone:410-228-6243
Mailing Address - Fax:410-901-4011
Practice Address - Street 1:830 CHESAPEAKE DR
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21613-9408
Practice Address - Country:US
Practice Address - Phone:410-228-6243
Practice Address - Fax:410-901-4011
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD51639207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G70225Medicare UPIN