Provider Demographics
NPI:1093809394
Name:SAKMAR, KATHERINE A (MD)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:A
Last Name:SAKMAR
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 1:300 BROADWAY
Mailing Address - Street 2:MASSACHUSETTS GENERAL HOSPITAL HEALTHCARE CENTER
Mailing Address - City:REVERE
Mailing Address - State:MA
Mailing Address - Zip Code:02151-5009
Mailing Address - Country:US
Mailing Address - Phone:781-485-1000
Mailing Address - Fax:781-286-5418
Practice Address - Street 1:300 BROADWAY
Practice Address - Street 2:MGH HEALTHCARE CENTER
Practice Address - City:REVERE
Practice Address - State:MA
Practice Address - Zip Code:02151-5009
Practice Address - Country:US
Practice Address - Phone:781-485-1000
Practice Address - Fax:781-286-5418
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD 425719207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAE12400Medicare UPIN