Provider Demographics
NPI:1851302988
Name:GADE-PULIDO, KAREN (MD)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:GADE-PULIDO
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 1:270 E STATE ST STE G110
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:44601-4380
Mailing Address - Country:US
Mailing Address - Phone:330-596-6515
Mailing Address - Fax:330-596-6517
Practice Address - Street 1:270 E STATE ST STE G110
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-4380
Practice Address - Country:US
Practice Address - Phone:330-596-6515
Practice Address - Fax:330-596-6517
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35070357208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000141767OtherANTHEM
OH0312656Medicaid
OH250011246OtherRAILROAD MEDICARE
OH341898905AOtherAULTCARE
OH341898905027OtherCARESOURCE
OH341750133AOtherSUMMACARE
OH733365OtherBUCKEYE COMM HEALTH PLAN
OH341898905027OtherCARESOURCE
OH0312656Medicaid
OH0812087Medicare PIN
OH4179211Medicare PIN