Healthcare Provider Details

I. General information

NPI: 1275670135
Provider Name (Legal Business Name): KAREN MAZIE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 11/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3912 GEORGIA AVE NW
WASHINGTON DC
20011-5861
US

IV. Provider business mailing address

1345 OTIS PL NW
WASHINGTON DC
20010-3436
US

V. Phone/Fax

Practice location:
  • Phone: 202-420-7131
  • Fax:
Mailing address:
  • Phone: 202-329-1230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD035145
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: