Provider Demographics
NPI:1003812090
Name:SYLVARA, KAREN A (DO)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:A
Last Name:SYLVARA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:502 S BALTIMORE ST
Mailing Address - Street 2:
Mailing Address - City:KIRKSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63501-3728
Mailing Address - Country:US
Mailing Address - Phone:660-665-5570
Mailing Address - Fax:660-665-2898
Practice Address - Street 1:502 S BALTIMORE ST
Practice Address - Street 2:
Practice Address - City:KIRKSVILLE
Practice Address - State:MO
Practice Address - Zip Code:63501-3728
Practice Address - Country:US
Practice Address - Phone:660-665-5570
Practice Address - Fax:660-665-2898
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-23
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO101191207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO243370202Medicaid
MO243370202Medicaid
MOF27953Medicare UPIN