Provider Demographics
NPI:1386693489
Name:STEIN, KAREN SHERRILL (MD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:SHERRILL
Last Name:STEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:906B MAR WALT DR
Mailing Address - Street 2:
Mailing Address - City:FORT WALTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32547-6752
Mailing Address - Country:US
Mailing Address - Phone:850-301-2020
Mailing Address - Fax:850-301-2023
Practice Address - Street 1:906B MAR WALT DR
Practice Address - Street 2:
Practice Address - City:FORT WALTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:32547-6752
Practice Address - Country:US
Practice Address - Phone:850-301-2020
Practice Address - Fax:850-301-2023
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 55866207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL371458600Medicaid
FL17773Medicare ID - Type Unspecified
FL371458600Medicaid