Healthcare Provider Details

I. General information

NPI: 1891954400
Provider Name (Legal Business Name): KAREN EILEEN GARCIA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2008
Last Update Date: 11/27/2023
Certification Date: 10/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 JOHN ST STE M-351
KALAMAZOO MI
49007-5358
US

IV. Provider business mailing address

601 JOHN ST STE M352
KALAMAZOO MI
49007-5341
US

V. Phone/Fax

Practice location:
  • Phone: 269-341-6800
  • Fax: 269-341-7703
Mailing address:
  • Phone: 269-341-8986
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number5101017697
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: