MEDICARE: DR. KAREN ANN NEAR 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	207RI0200X	Infectious Disease Physician	4301063397	MI
2	208D00000X	General Practice Physician	4301063397	MI
3	207R00000X	Internal Medicine Physician	4301063397	MI

General Provider Information

NPI Number	:	1790844272
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAREN ANN NEAR M.D.

Provider Business Mailing Address
First Line	:	3300 GREGG RD
Second Line	:
City	:	BROOKEVILLE
State	:	MD
Zip	:	20833-1103
Country	:	US
Telephone Number	:	301-260-9415
Fax Number	:

Provider Business Practice Location Address
First Line	:	3300 GREGG ROAD
Second Line	:
City	:	BROOKEVILLE
State	:	MD
Zip	:	20833
Country	:	US
Telephone Number	:	301-260-9415
Fax Number	:

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

Provider Enumeration Date	:	12/08/2006
Last Update Date	:	08/18/2018

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