Provider Demographics
NPI:1528123387
Name:BISSELL, KAREN R (MD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:R
Last Name:BISSELL
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:60 COMMERCE PLZ
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:NC
Mailing Address - Zip Code:28372-7386
Mailing Address - Country:US
Mailing Address - Phone:910-521-2900
Mailing Address - Fax:910-775-3165
Practice Address - Street 1:1212 S WALNUT ST
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:NC
Practice Address - Zip Code:28340-1848
Practice Address - Country:US
Practice Address - Phone:910-628-6711
Practice Address - Fax:910-628-5735
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2011-08-15
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Provider Licenses
StateLicense IDTaxonomies
NC26314207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
C86401Medicare UPIN