Provider Demographics
NPI:1326265786
Name:ROBINETT, KATHRYN SARAH (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:SARAH
Last Name:ROBINETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KATHRYN
Other - Middle Name:SARAH
Other - Last Name:WALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 64442
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4442
Mailing Address - Country:US
Mailing Address - Phone:410-328-1512
Mailing Address - Fax:410-328-0177
Practice Address - Street 1:22 S GREENE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1544
Practice Address - Country:US
Practice Address - Phone:410-328-1512
Practice Address - Fax:410-328-0177
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD68167207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD6267364OtherAETNA HMO
MD029197800Medicaid
MDS062-0439OtherCAREFIRST BC/BS REGIONAL
MD7632919OtherAETNA PPO
MD964141-02 & 03OtherCAREFIRST BC/BS
MDKS04BW F551-0062OtherCAREFIRST
MDKS04OtherMEDICARE GROUP PTAN
MD182084ZCEAMedicare PIN
MD964141-02 & 03OtherCAREFIRST BC/BS
MDKS04BW F551-0062OtherCAREFIRST