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General NPI Number Information
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NPI Number | 1699706119
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Entity Type | Individual
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Provider Name | KAREN L BETTEN M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 09/27/2020
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Provider Practice Location Address
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Address Line | 8191 MOORSBRIDGE RD STE A
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City | PORTAGE
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State | MI
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Zip | 49024-7417
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Country | US
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Telephone | 269-779-0797
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Fax | 888-287-4873
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Provider Business Mailing Address
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Address Line | 8191 MOORSBRIDGE RD STE A
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City | PORTAGE
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State | MI
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Zip | 49024-7417
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Country | US
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Telephone | 269-779-0797
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Fax | 888-287-4873
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 46165-20
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4301078902
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License Number State | MI
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