Healthcare Provider Details

I. General information

NPI: 1922044643
Provider Name (Legal Business Name): ANTHONY GEORGE KAREM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 11/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7101 W HWY 22
CRESTWOOD KY
40014
US

IV. Provider business mailing address

PO BOX 94670
OKLAHOMA CITY OK
73143-4670
US

V. Phone/Fax

Practice location:
  • Phone: 502-241-6567
  • Fax: 502-241-6567
Mailing address:
  • Phone: 405-682-3303
  • Fax: 405-384-6793

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number28815
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number28815
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: