Healthcare Provider Details

I. General information

NPI: 1023059011
Provider Name (Legal Business Name): KAREN L KRIZA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAREN KRIZA DEVRIES

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 05/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

295 MIDLAND PARKWAY
SUMMERVILLE SC
29483
US

IV. Provider business mailing address

PO BOX 11450
WESTMINSTER CA
92685
US

V. Phone/Fax

Practice location:
  • Phone: 843-832-5000
  • Fax:
Mailing address:
  • Phone: 800-509-8138
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number22679
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: