Provider Demographics
NPI:1639132814
Name:WOLD, KAREN TRYGG (MD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:TRYGG
Last Name:WOLD
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 1:1985 TATE BLVD SE
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-1433
Mailing Address - Country:US
Mailing Address - Phone:828-328-4449
Mailing Address - Fax:828-328-4809
Practice Address - Street 1:1985 TATE BLVD SE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-1433
Practice Address - Country:US
Practice Address - Phone:828-328-4449
Practice Address - Fax:828-328-4809
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC00-36857207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8988749Medicaid
NC8988749Medicaid
NCE59358Medicare UPIN