Healthcare Provider Details

I. General information

NPI: 1225296247
Provider Name (Legal Business Name): KARENROSE R CONTRERAS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2008
Last Update Date: 09/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4199 GATEWAY BLVD, SUITE 3100
NEWBURGH IN
47630-8940
US

IV. Provider business mailing address

PO BOX 637273
CINCINNATI OH
45263-7273
US

V. Phone/Fax

Practice location:
  • Phone: 812-842-4550
  • Fax:
Mailing address:
  • Phone: 812-842-4550
  • Fax: 812-842-4549

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number01070078A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: