Provider Demographics
NPI:1023042512
Name:KARASON, MICHAEL CAL (DPM)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:CAL
Last Name:KARASON
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:PO BOX 528
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17022-0528
Mailing Address - Country:US
Mailing Address - Phone:310-854-0203
Mailing Address - Fax:717-564-1304
Practice Address - Street 1:8709 BEVERLY BLVD
Practice Address - Street 2:
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90048-1803
Practice Address - Country:US
Practice Address - Phone:310-854-0203
Practice Address - Fax:717-564-1304
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4538213ES0103X
PASC0041171213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA521941Medicare UPIN
CAE4538Medicare UPIN