Provider Demographics
NPI:1396719290
Name:GADOL, KAREN LEMACKS (PA-C)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:LEMACKS
Last Name:GADOL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1694 OLD TOWNE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-5045
Mailing Address - Country:US
Mailing Address - Phone:843-571-3100
Mailing Address - Fax:843-766-7798
Practice Address - Street 1:1694 OLD TOWNE RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-5045
Practice Address - Country:US
Practice Address - Phone:843-571-3100
Practice Address - Fax:843-766-7798
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2012-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC531363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCS67345Medicare ID - Type Unspecified
SCS67345Medicare UPIN