Provider Demographics
NPI:1396784674
Name:HART, KAREN MARTIN (MD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:MARTIN
Last Name:HART
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:860 OMNI BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4430
Mailing Address - Country:US
Mailing Address - Phone:757-232-8769
Mailing Address - Fax:757-232-8875
Practice Address - Street 1:813 INDEPENDENCE BLVD STE A
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-6004
Practice Address - Country:US
Practice Address - Phone:757-301-7729
Practice Address - Fax:757-301-7837
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2020-02-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101045432207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
080007636Medicare ID - Type Unspecified
E89541Medicare UPIN