Individual provider · NPI-1
Steven L Karassik, MD
Dermatology · Ketchum, ID
NPI number1891748117
StatusActive
Last updated in NPPESSep 24, 2013
Details
- NPI
- 1891748117
- Entity type
- Individual (NPI-1)
- Name
- Steven L Karassik
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 18, 2006
- Last updated
- Sep 24, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207N00000X | Dermatology | M5900 | ID | Yes |
| 207ND0900X | Dermatology, Dermatopathology | M5900 | ID |
Practice location
191 W 5th StKetchum, ID 83340
Phone 208-725-2171
Mailing address
190 E Bannock StBoise, ID 83712-6241
Phone 208-381-2222
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