Provider Demographics
NPI:1265571152
Name:MOUNZER, KARAM C (MD)
Entity type:Individual
Prefix:
First Name:KARAM
Middle Name:C
Last Name:MOUNZER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1233 LOCUST ST FL 3
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-5400
Mailing Address - Country:US
Mailing Address - Phone:215-985-4448
Mailing Address - Fax:215-732-1145
Practice Address - Street 1:1233 LOCUST ST FL 4
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5459
Practice Address - Country:US
Practice Address - Phone:215-790-1788
Practice Address - Fax:215-732-5490
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD055419L207RI0200X
PAMD055419-L207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA18177300001Medicaid
PA039813Medicare PIN
PAG55265Medicare UPIN
PA18177300001Medicaid