Provider Demographics
NPI:1104985647
Name:MACHELEDT, KAREN L (MD)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:L
Last Name:MACHELEDT
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 1:100 LANDSDOWNE ST
Mailing Address - Street 2:#907
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-4203
Mailing Address - Country:US
Mailing Address - Phone:617-945-1196
Mailing Address - Fax:
Practice Address - Street 1:100 LANDSDOWNE ST
Practice Address - Street 2:#907
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-4203
Practice Address - Country:US
Practice Address - Phone:617-945-1196
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA230373207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine