Provider Demographics
NPI:1548686447
Name:KARELS, JAKE (MD)
Entity type:Individual
Prefix:DR
First Name:JAKE
Middle Name:
Last Name:KARELS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1422 E MILLBROOK RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-5179
Mailing Address - Country:US
Mailing Address - Phone:198-788-5969
Mailing Address - Fax:
Practice Address - Street 1:1422 E MILLBROOK RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-5179
Practice Address - Country:US
Practice Address - Phone:198-788-5969
Practice Address - Fax:919-878-0744
Is Sole Proprietor?:No
Enumeration Date:2014-03-16
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE18800207Q00000X
NC2021-03367207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE18800Medicare PIN