MEDICARE: KARL W. SORENSON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	75031	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710952437
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARL W. SORENSON M.D.

Provider Business Mailing Address
First Line	:	145 ROSEMARY ST STE D
Second Line	:
City	:	NEEDHAM
State	:	MA
Zip	:	02494-3259
Country	:	US
Telephone Number	:	781-453-8500
Fax Number	:

Provider Business Practice Location Address
First Line	:	145 ROSEMARY ST STE D
Second Line	:
City	:	NEEDHAM
State	:	MA
Zip	:	02494-3259
Country	:	US
Telephone Number	:	781-453-8500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/17/2006
Last Update Date	:	04/11/2019

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