Provider Demographics
NPI:1407348923
Name:MARCHETTI, KATHRYN ANN (MD)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ANN
Last Name:MARCHETTI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5200 CENTRE AVENUE
Mailing Address - Street 2:SUITE 209, SHADYSIDE MEDICAL BUILDING
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15232
Mailing Address - Country:US
Mailing Address - Phone:412-605-3020
Mailing Address - Fax:412-605-3030
Practice Address - Street 1:5200 CENTRE AVENUE
Practice Address - Street 2:SUITE 209, SHADYSIDE MEDICAL BUILDING
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232
Practice Address - Country:US
Practice Address - Phone:412-605-3020
Practice Address - Fax:412-605-3030
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-31
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301115382390200000X
PAMD481434208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program