Basic Information
Provider Information
NPI: 1457589533
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ISAACS
FirstName: KAREN
MiddleName: MELINDA
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 936857
Address2:  
City: ATLANTA
State: GA
PostalCode: 311936857
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 2523 DELANEY AVE
Address2:  
City: WILMINGTON
State: NC
PostalCode: 284036003
CountryCode: US
TelephoneNumber: 9107729202
FaxNumber: 9107729452
Other Information
ProviderEnumerationDate: 06/26/2009
LastUpdateDate: 05/27/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/27/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X201101212NCY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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