Provider Demographics
NPI:1205938461
Name:WINER, KAREN K (MD)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:K
Last Name:WINER
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:PO BOX 299
Mailing Address - Street 2:
Mailing Address - City:BURTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20866-0299
Mailing Address - Country:US
Mailing Address - Phone:301-570-9700
Mailing Address - Fax:301-260-2838
Practice Address - Street 1:8830 CAMERON CT
Practice Address - Street 2:SUITE 402
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4114
Practice Address - Country:US
Practice Address - Phone:301-961-6020
Practice Address - Fax:301-260-2838
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD35556208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC3477OtherBLUE SHIELD OF DC
MDLY67OtherBLUE CROSS OF MD
DC3477OtherBLUE SHIELD OF DC