Basic Information
| Provider Information | |||||||||
| NPI: | 1922072644 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MICHELS-ASHWOOD | ||||||||
| FirstName: | KARIN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 64 BLACK ROCK AVE | ||||||||
| Address2: | |||||||||
| City: | BRIDGEPORT | ||||||||
| State: | CT | ||||||||
| PostalCode: | 066051200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2035795000 | ||||||||
| FaxNumber: | 2035795113 | ||||||||
| Practice Location | |||||||||
| Address1: | 64 BLACK ROCK AVE | ||||||||
| Address2: | |||||||||
| City: | BRIDGEPORT | ||||||||
| State: | CT | ||||||||
| PostalCode: | 066051200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2035795000 | ||||||||
| FaxNumber: | 2035795113 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/17/2006 | ||||||||
| LastUpdateDate: | 03/14/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 032193 | CT | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.