Healthcare Provider Details

I. General information

NPI: 1407996481
Provider Name (Legal Business Name): KAREN ELIZABETH CALDWELL MD-PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 02/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

269 UNION ST
LYNN MA
01901-1314
US

IV. Provider business mailing address

694 WESTERN AVE
LYNN MA
01905-2229
US

V. Phone/Fax

Practice location:
  • Phone: 781-596-2502
  • Fax: 781-596-3966
Mailing address:
  • Phone: 781-595-7348
  • Fax: 781-598-3583

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number231625
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: