Healthcare Provider Details

I. General information

NPI: 1205938461
Provider Name (Legal Business Name): KAREN K WINER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2006
Last Update Date: 10/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8830 CAMERON CT SUITE 402
SILVER SPRING MD
20910-4114
US

IV. Provider business mailing address

PO BOX 299
BURTONSVILLE MD
20866-0299
US

V. Phone/Fax

Practice location:
  • Phone: 301-961-6020
  • Fax: 301-260-2838
Mailing address:
  • Phone: 301-570-9700
  • Fax: 301-260-2838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD35556
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: