Provider Demographics
NPI:1174517734
Name:LUPARELLO, KAREN M (DO)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:M
Last Name:LUPARELLO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2295 WOODLAND TRL
Mailing Address - Street 2:
Mailing Address - City:HILLSDALE
Mailing Address - State:MI
Mailing Address - Zip Code:49242-3000
Mailing Address - Country:US
Mailing Address - Phone:517-437-1967
Mailing Address - Fax:
Practice Address - Street 1:50 W CARLETON RD
Practice Address - Street 2:
Practice Address - City:HILLSDALE
Practice Address - State:MI
Practice Address - Zip Code:49242-1202
Practice Address - Country:US
Practice Address - Phone:517-439-2020
Practice Address - Fax:517-437-5577
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIKL011914207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4495541Medicaid
MI0N64420001Medicare ID - Type UnspecifiedGROUP
MIG20612Medicare UPIN