Provider Demographics
NPI:1881155877
Name:KARP, STEPHEN PHILIP (DO)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:PHILIP
Last Name:KARP
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:736 CAMBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-2907
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9500 E IRONWOOD SQUARE DR STE 125
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4582
Practice Address - Country:US
Practice Address - Phone:928-852-2540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-31
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA285433207LP2900X
390200000X
AZ011048207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA285433OtherMASSACHUSETTS LICENCE
MA00002136874Medicaid
MA011048OtherARIZONA BOARD OF OSTEOPATHIC EXAMINERS IN MEDICINE AND SURGERY