Healthcare Provider Details

I. General information

NPI: 1982306635
Provider Name (Legal Business Name): KARIN CHA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KARIN CHERNIAK DO

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 04/02/2024
Certification Date: 04/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 SE BLUE PKWY
LEES SUMMIT MO
64063-1007
US

IV. Provider business mailing address

600 NW MURRAY RD STE 204
LEES SUMMIT MO
64081-1227
US

V. Phone/Fax

Practice location:
  • Phone: 816-434-3678
  • Fax:
Mailing address:
  • Phone: 816-434-3678
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: