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NPI Code Detail

MEDICARE: KAREN A HEARST MD

MEDICARE: KAREN A HEARST MD
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
1207Q00000XFamily Medicine Physician0101046978VA

General Provider Information

NPI Number : 1912985250
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAREN A HEARST MD
Provider Business Mailing Address
First Line : 1395 NW 167TH ST
Second Line :
City : MIAMI GARDENS
State : FL
Zip : 33169-5710
Country : US
Telephone Number : 804-504-7980
Fax Number : 804-554-5387
Provider Business Practice Location Address
First Line : 524 SOUTHPARK BLVD
Second Line :
City : COLONIAL HEIGHTS
State : VA
Zip : 23834-3609
Country : US
Telephone Number : 804-504-7980
Fax Number : 804-554-5387
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2006
Last Update Date : 11/16/2021

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Directions to “ KAREN A HEARST MD” Practice Location

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