Provider Demographics
NPI:1962615005
Name:PARKER, KAREN ELAINE (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:ELAINE
Last Name:PARKER
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9500 EUCLID AVE
Mailing Address - Street 2:M2 ANNEX
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-0001
Mailing Address - Country:US
Mailing Address - Phone:216-445-1472
Mailing Address - Fax:216-445-1767
Practice Address - Street 1:9500 EUCLID AVE
Practice Address - Street 2:M2 ANNEX
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-0001
Practice Address - Country:US
Practice Address - Phone:216-445-1472
Practice Address - Fax:216-445-1767
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.011519207R00000X
OH35.094370207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2989020Medicaid
OHPA4276681Medicare PIN
OHP00760948Medicare PIN