Provider Demographics
NPI:1942393848
Name:KARUZA, ANTHONY S (DPM)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:S
Last Name:KARUZA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:383 E LAUREL RD
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-9773
Mailing Address - Country:US
Mailing Address - Phone:360-398-2369
Mailing Address - Fax:360-398-1959
Practice Address - Street 1:383 E LAUREL RD
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-9773
Practice Address - Country:US
Practice Address - Phone:360-398-2369
Practice Address - Fax:360-398-1959
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA0000289213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1101740Medicaid
WA4877710001Medicare NSC
WAGAB01684Medicare PIN
WAT03147Medicare UPIN