Provider Demographics
NPI:1982837415
Name:KARANAM, KARTHIK P (MD)
Entity Type:Individual
Prefix:DR
First Name:KARTHIK
Middle Name:P
Last Name:KARANAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 E CHEVES ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29506-2708
Mailing Address - Country:US
Mailing Address - Phone:843-669-6694
Mailing Address - Fax:843-669-2500
Practice Address - Street 1:1100 E CHEVES ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506-2708
Practice Address - Country:US
Practice Address - Phone:843-669-6694
Practice Address - Fax:843-669-2500
Is Sole Proprietor?:No
Enumeration Date:2009-09-01
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT192193207R00000X
IN01069628A207R00000X
SCMD37981207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201027410Medicaid
IN201027410Medicaid
INM400065108Medicare PIN
INM400048631Medicare PIN