Provider Demographics
NPI:1275638710
Name:CHRETIEN, KATHERINE CHANG (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:CHANG
Last Name:CHRETIEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:50 IRVING ST NW
Mailing Address - Street 2:MEDICAL SERVICE (111)
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20422-0001
Mailing Address - Country:US
Mailing Address - Phone:202-745-8390
Mailing Address - Fax:202-745-8184
Practice Address - Street 1:50 IRVING ST NW
Practice Address - Street 2:MEDICAL SERVICE (111)
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20422-0001
Practice Address - Country:US
Practice Address - Phone:202-745-8390
Practice Address - Fax:202-745-8184
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD60240207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine