Basic Information
Provider Information
NPI: 1306820212
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KARP
FirstName: EDWARD
MiddleName: STEPHEN
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6465 WAYZATA BLVD
Address2: STE 315
City: ST LOUIS PARK
State: MN
PostalCode: 554261728
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 14000 FAIRVIEW DR
Address2:  
City: BURNSVILLE
State: MN
PostalCode: 553375713
CountryCode: US
TelephoneNumber: 9529938700
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/05/2005
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000X22877MNY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


Home