Provider Demographics
NPI:1871947085
Name:OTEYZA, KAREN BARCENILLA (MD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:BARCENILLA
Last Name:OTEYZA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46499 GALWAY DR
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48374-3853
Mailing Address - Country:US
Mailing Address - Phone:248-345-0385
Mailing Address - Fax:
Practice Address - Street 1:3901 CHYSLER SERVICE DRIVE, SUITE 5A
Practice Address - Street 2:TOLAN PARK MEDICAL BUILDING
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201
Practice Address - Country:US
Practice Address - Phone:313-577-1808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-14
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program