Provider Demographics
NPI:1538243662
Name:KOERMER, KAREN L (PT)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:L
Last Name:KOERMER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:
Other - Last Name:PIROVOLIDIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:PO BOX 179
Mailing Address - Street 2:
Mailing Address - City:FOREST HILL
Mailing Address - State:MD
Mailing Address - Zip Code:21050-0179
Mailing Address - Country:US
Mailing Address - Phone:410-838-9600
Mailing Address - Fax:410-838-8530
Practice Address - Street 1:2304 E CHURCHVILLE RD
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-1721
Practice Address - Country:US
Practice Address - Phone:410-734-6556
Practice Address - Fax:410-734-6557
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD17545225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD5652475OtherAETNA PPO
MD221MQ505Medicare PIN