Healthcare Provider Details
I. General information
NPI: 1477592244
Provider Name (Legal Business Name): KAREN E KONKEL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/06/2006
Last Update Date: 09/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7801 YORK RD SUITE102
TOWSON MD
21204-7446
US
IV. Provider business mailing address
7801 YORK RD SUITE102
TOWSON MD
21204-7446
US
V. Phone/Fax
- Phone: 410-769-4920
- Fax: 410-296-4205
- Phone: 410-769-4920
- Fax: 410-296-4205
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207QA0505X |
| Taxonomy | Adult Medicine Physician |
| License Number | D50736 |
| License Number State | MD |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: