Provider Demographics
NPI:1992713440
Name:CLONINGER, KAREN
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:CLONINGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:447 MCALISTER RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLNTON
Mailing Address - State:NC
Mailing Address - Zip Code:28092-4114
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:447 MCALISTER RD
Practice Address - Street 2:LINCOLN MEDICAL PLAZA II
Practice Address - City:LINCOLNTON
Practice Address - State:NC
Practice Address - Zip Code:28092-4114
Practice Address - Country:US
Practice Address - Phone:980-212-6300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200000200207RC0000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891253AMedicaid
P00245243OtherRAILROAD MEDICARE
SCN00244Medicaid
NC1253AOtherBCBS
NC891253AMedicaid
SCN00244Medicaid