Provider Demographics
NPI:1033179635
Name:GOETZ, KATHARINE M (MD)
Entity Type:Individual
Prefix:
First Name:KATHARINE
Middle Name:M
Last Name:GOETZ
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 1:3380 BLVD OF THE ALLIES
Mailing Address - Street 2:SUITE 1
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-3125
Mailing Address - Country:US
Mailing Address - Phone:412-621-7575
Mailing Address - Fax:412-621-6353
Practice Address - Street 1:3380 BLVD OF THE ALLIES
Practice Address - Street 2:SUITE 1
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-3125
Practice Address - Country:US
Practice Address - Phone:412-621-7575
Practice Address - Fax:412-621-6353
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD039751L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA401634Medicare ID - Type Unspecified
PAC33414Medicare UPIN