MEDICARE: DR. KARLA MARIE KASZA D.O.

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	207R00000X	Internal Medicine Physician	5101018818	MI

General Provider Information

NPI Number	:	1891006987
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KARLA MARIE KASZA D.O.

Provider Business Mailing Address
First Line	:	18580 FORT ST
Second Line	:
City	:	RIVERVIEW
State	:	MI
Zip	:	48193-7442
Country	:	US
Telephone Number	:	734-479-8800
Fax Number	:	734-283-4861

Provider Business Practice Location Address
First Line	:	18580 FORT ST
Second Line	:
City	:	RIVERVIEW
State	:	MI
Zip	:	48193-7442
Country	:	US
Telephone Number	:	734-479-8800
Fax Number	:	734-283-4861

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

Provider Enumeration Date	:	06/23/2010
Last Update Date	:	03/16/2021

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