Provider Demographics
NPI:1083942270
Name:KORTE, KATIA CHRISTINE (MD)
Entity Type:Individual
Prefix:DR
First Name:KATIA
Middle Name:CHRISTINE
Last Name:KORTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATIA
Other - Middle Name:CHRISTINE
Other - Last Name:DE MELO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:54 COURT ST
Mailing Address - Street 2:
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-3201
Mailing Address - Country:US
Mailing Address - Phone:508-821-2500
Mailing Address - Fax:
Practice Address - Street 1:130 QUINCY AVE
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02302-2803
Practice Address - Country:US
Practice Address - Phone:508-941-7268
Practice Address - Fax:508-941-7850
Is Sole Proprietor?:No
Enumeration Date:2009-11-26
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA255569207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110097726AMedicaid