Healthcare Provider Details

I. General information

NPI: 1437268455
Provider Name (Legal Business Name): KAREN RUTH HAUDE MPAS PAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAREN HAUDE SCHMIDT MPAS PAC

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 02/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4240 MUNSON ST NW SUITE B
CANTON OH
44718
US

IV. Provider business mailing address

1038 DELL CIR NW
CANTON OH
44720-3252
US

V. Phone/Fax

Practice location:
  • Phone: 330-492-2327
  • Fax: 330-492-0953
Mailing address:
  • Phone: 330-494-2072
  • Fax: 330-494-2072

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50001125
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: