Healthcare Provider Details

I. General information

NPI: 1184866402
Provider Name (Legal Business Name): KAREN ELAINE CARDON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2009
Last Update Date: 12/14/2023
Certification Date: 12/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 MONTANO RD NW STE A1
ALBUQUERQUE NM
87107-5200
US

IV. Provider business mailing address

PO BOX 740018
ATLANTA GA
30374-0018
US

V. Phone/Fax

Practice location:
  • Phone: 505-777-3003
  • Fax: 505-808-4976
Mailing address:
  • Phone: 773-352-1517
  • Fax: 312-929-0373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD2012-0263
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: