Provider Demographics
NPI:1174597728
Name:SIMON, KAREN (MD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:
Last Name:SIMON
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 1:1 MEDICAL CENTER BLVD
Mailing Address - Street 2:ACP #334
Mailing Address - City:CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19013-3902
Mailing Address - Country:US
Mailing Address - Phone:610-872-7660
Mailing Address - Fax:610-876-2628
Practice Address - Street 1:1 MEDICAL CENTER BLVD
Practice Address - Street 2:ACP #334
Practice Address - City:CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19013-3902
Practice Address - Country:US
Practice Address - Phone:610-872-7660
Practice Address - Fax:610-876-2628
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD034784207V00000X
PAMD433955207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC404650100Medicaid
DC010061911Medicaid
DC035611900Medicaid
PA102106880Medicaid
DC035611900Medicaid
PA124454Medicare PIN