Provider Demographics
NPI:1083971436
Name:VIOLA, KATHLEEN VICTORIA (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:VICTORIA
Last Name:VIOLA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:10 FILA WAY
Mailing Address - Street 2:
Mailing Address - City:SPARKS GLENCOE
Mailing Address - State:MD
Mailing Address - Zip Code:21152-9452
Mailing Address - Country:US
Mailing Address - Phone:410-223-2620
Mailing Address - Fax:877-437-7288
Practice Address - Street 1:10 FILA WAY
Practice Address - Street 2:
Practice Address - City:SPARKS GLENCOE
Practice Address - State:MD
Practice Address - Zip Code:21152-9452
Practice Address - Country:US
Practice Address - Phone:410-223-2620
Practice Address - Fax:877-437-7288
Is Sole Proprietor?:No
Enumeration Date:2012-04-23
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0097731207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY390200000XOtherSTUDENT IN HEALTHCARE