MEDICARE: DR. KAREN FICKEL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	41543	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	007006261I	OTHER		HUMANA

General Provider Information

NPI Number	:	1336190255
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAREN FICKEL MD

Provider Business Mailing Address
First Line	:	840 N 87TH ST
Second Line	:	SARGEANT HEALTH CENTER
City	:	MILWAUKEE
State	:	WI
Zip	:	53226-3586
Country	:	US
Telephone Number	:	414-805-5540
Fax Number	:	414-805-7878

Provider Business Practice Location Address
First Line	:	840 N 87TH ST
Second Line	:	SARGEANT HEALTH CENTER
City	:	MILWAUKEE
State	:	WI
Zip	:	53226-3586
Country	:	US
Telephone Number	:	414-805-5540
Fax Number	:	414-805-7878

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2006
Last Update Date	:	12/19/2012

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