1174540827 NPI number — DR. EVELYN MARLENE KARSON PHD MD

Table of content: DR. EVELYN MARLENE KARSON PHD MD (NPI 1174540827)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174540827 NPI number — DR. EVELYN MARLENE KARSON PHD MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KARSON
Provider First Name:
EVELYN
Provider Middle Name:
MARLENE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHD MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1174540827
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/26/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5824 CONWAY RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BETHESDA
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20817-3400
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-897-8175
Provider Business Mailing Address Fax Number:
301-493-6107

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10401 OLD GEORGETOWN RD
Provider Second Line Business Practice Location Address:
SUITE 307
Provider Business Practice Location Address City Name:
BETHESDA
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20814-1911
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-571-5190
Provider Business Practice Location Address Fax Number:
301-571-5195
Provider Enumeration Date:
07/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207SG0201X , with the licence number:  D0035033 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207SG0201X , with the licence number: MD13800 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207V00000X , with the licence number: D0035033 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207V00000X , with the licence number: MD13800 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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