Provider Demographics
NPI:1407033426
Name:VAN PATTEN, KATHARINE (MD)
Entity Type:Individual
Prefix:
First Name:KATHARINE
Middle Name:
Last Name:VAN PATTEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3300 OAKDALE AVE N
Mailing Address - Street 2:SURGICAL PATHOLOGY DEPARTMENT
Mailing Address - City:ROBBINSDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55422-2926
Mailing Address - Country:US
Mailing Address - Phone:763-581-4150
Mailing Address - Fax:763-581-4151
Practice Address - Street 1:3300 OAKDALE AVE N
Practice Address - Street 2:SURGICAL PATHOLOGY DEPARTMENT
Practice Address - City:ROBBINSDALE
Practice Address - State:MN
Practice Address - Zip Code:55422
Practice Address - Country:US
Practice Address - Phone:763-581-4150
Practice Address - Fax:763-581-4151
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-22
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN53845207ZP0101X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology