MEDICARE: DR. KAREN DIETRICH SCANLAN M.D.

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	207RH0003X	Hematology & Oncology Physician	81177	MA

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

General Provider Information

NPI Number	:	1639176662
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAREN DIETRICH SCANLAN M.D.

Provider Business Mailing Address
First Line	:	825 WASHINGTON ST
Second Line	:	SUITE 340
City	:	NORWOOD
State	:	MA
Zip	:	02062-3441
Country	:	US
Telephone Number	:	781-762-5586
Fax Number	:	781-762-0634

Provider Business Practice Location Address
First Line	:	825 WASHINGTON ST
Second Line	:	SUITE 340
City	:	NORWOOD
State	:	MA
Zip	:	02062-3441
Country	:	US
Telephone Number	:	781-762-5586
Fax Number	:	781-762-0634

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

Provider Enumeration Date	:	07/06/2005
Last Update Date	:	06/16/2010

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Directions to “ DR. KAREN DIETRICH SCANLAN M.D.” Practice Location

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