Provider Demographics
NPI:1396900619
Name:DUNLAP, KAREN MARIE (OD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:MARIE
Last Name:DUNLAP
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:DUNLAP
Other - Last Name:PARKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:6201 GREENLEIGH AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLE RIVER
Mailing Address - State:MD
Mailing Address - Zip Code:21220-2004
Mailing Address - Country:US
Mailing Address - Phone:410-933-6423
Mailing Address - Fax:410-500-4266
Practice Address - Street 1:4924 CAMPBELL BLVD STE 100
Practice Address - Street 2:
Practice Address - City:NOTTINGHAM
Practice Address - State:MD
Practice Address - Zip Code:21236-5909
Practice Address - Country:US
Practice Address - Phone:443-442-2020
Practice Address - Fax:443-442-2021
Is Sole Proprietor?:No
Enumeration Date:2008-07-25
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG002120152W00000X
MDTA2072152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD019774200Medicaid
MD137769ZALTMedicare PIN