Provider Demographics
NPI:1174877187
Name:KING, KAREN LYNN (MD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:LYNN
Last Name:KING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KAREN
Other - Middle Name:LYNN
Other - Last Name:EWERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8 BALSAM AVE
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-9369
Mailing Address - Country:US
Mailing Address - Phone:207-373-0870
Mailing Address - Fax:
Practice Address - Street 1:8 BALSAM AVE
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-9369
Practice Address - Country:US
Practice Address - Phone:207-373-0870
Practice Address - Fax:207-373-0870
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-30
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD14521207V00000X, 207VG0400X, 207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics