Provider Demographics
NPI:1962472738
Name:HABENSTEIN, KAREN RUTH (MD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:RUTH
Last Name:HABENSTEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3532 EPHRAIM MCDOWELL DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205-3224
Mailing Address - Country:US
Mailing Address - Phone:502-456-6200
Mailing Address - Fax:502-456-6655
Practice Address - Street 1:3532 EPHRAIM MCDOWELL DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-3224
Practice Address - Country:US
Practice Address - Phone:502-456-6200
Practice Address - Fax:502-456-6655
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY25178207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100351660AMedicaid
KY64251788Medicaid
KY64251788Medicaid
E08926Medicare UPIN
KY1475603Medicare ID - Type UnspecifiedLOUISVILLE
IN100351660AMedicaid