Individual
KAREN GAYLE GANACIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
692A RITCHIE HWY, SEVERNA PARK, MD 21146-3971
(410) 721-2273
Mailing address
1600 GRANBY ST APT 456, NORFOLK, VA 23510-2661
(913) 683-5707
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
D86067
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
MD
Enumeration date
06/28/2010
Last updated
09/27/2018
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