Provider Demographics
NPI:1568439040
Name:POEHAILOS, KAREN DEMBECK (MD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:DEMBECK
Last Name:POEHAILOS
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 1:3150 SAGEBRUSH CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-7555
Mailing Address - Country:US
Mailing Address - Phone:434-996-4710
Mailing Address - Fax:
Practice Address - Street 1:400 ALTAIR PKWY STE 3100
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-7653
Practice Address - Country:US
Practice Address - Phone:614-360-9995
Practice Address - Fax:614-745-0165
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101046855208D00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5617081Medicaid
VAF29510Medicare UPIN
VA080007465Medicare ID - Type Unspecified