Provider Demographics
NPI:1316901127
Name:FORTUNE, KAREN (MD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:
Last Name:FORTUNE
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 1:20 RESEARCH PL STE 320
Mailing Address - Street 2:
Mailing Address - City:N CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01863-2455
Mailing Address - Country:US
Mailing Address - Phone:978-256-1858
Mailing Address - Fax:978-788-7890
Practice Address - Street 1:20 RESEARCH PL STE 320
Practice Address - Street 2:
Practice Address - City:N CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01863-2455
Practice Address - Country:US
Practice Address - Phone:978-256-1858
Practice Address - Fax:978-788-7890
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA159413174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1912179870OtherHEALTHNET SERVICES
MA1316901127OtherNETWORK HEALTH
MA1316901127OtherNETWORK
MA1316901127OtherHEALTH PLANS INC
MA1316901127OtherBMC HEALTH NET
MA1316901127OtherFALLON
MA1316901127OtherCIGNA
MA1316901127OtherAETNA
MA1316901127OtherNEIGHBORHOOD HEALTH PLAN
MA1316901127OtherHEALTHNET OF CA
MA1316901127OtherTUFTS
MA1912179870OtherHEALTHY START
MA3198219Medicaid
MAAA114657OtherHARVARD PILGRIM
MA1316901127OtherCHAMPUS/TRICARE
MA1316901127OtherUNITED HEALTH CARE
MA1316901127OtherHEALTHSOURCE
MA131690127OtherGREAT WEST
MA1316901127OtherPHCS
MAJ21558OtherBCBS MA
MA1316901127OtherFALLON