Provider Demographics
NPI:1043609373
Name:MARTZ, KATHERINE LYNN (MD)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:LYNN
Last Name:MARTZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:LYNN
Other - Last Name:MARCUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1 CHILDRENS PL MSC 8208-0016-01
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110
Mailing Address - Country:US
Mailing Address - Phone:314-454-2527
Mailing Address - Fax:314-747-8880
Practice Address - Street 1:1 CHILDRENS PL MSC 8208-0016-01
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110
Practice Address - Country:US
Practice Address - Phone:314-454-2527
Practice Address - Fax:314-747-8880
Is Sole Proprietor?:No
Enumeration Date:2015-01-09
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022016426208000000X
MA286862208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics