Healthcare Provider Details
I. General information
NPI: 1053380386
Provider Name (Legal Business Name): KAREN M. HUHN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/17/2006
Last Update Date: 04/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
133 BROOKLINE AVE
BOSTON MA
02215-3904
US
IV. Provider business mailing address
147 MILK ST PROVIDER ENROLLMENT 9TH FLOOR
BOSTON MA
02109-4806
US
V. Phone/Fax
- Phone: 617-421-2340
- Fax:
- Phone: 617-559-8051
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207ZD0900X |
| Taxonomy | Dermatopathology (Pathology) Physician |
| License Number | 213000 |
| License Number State | MA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207ZP0102X |
| Taxonomy | Anatomic Pathology & Clinical Pathology Physician |
| License Number | 213000 |
| License Number State | MA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: