Provider Demographics
NPI:1417937574
Name:CATH, ANNE MARGARET (MD)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:MARGARET
Last Name:CATH
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 1:4600 MEMORIAL DR
Mailing Address - Street 2:STE. 440
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62226-5368
Mailing Address - Country:US
Mailing Address - Phone:618-236-8000
Mailing Address - Fax:618-236-8005
Practice Address - Street 1:4600 MEMORIAL DR
Practice Address - Street 2:STE. 440
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62226-5368
Practice Address - Country:US
Practice Address - Phone:618-236-8000
Practice Address - Fax:618-236-8005
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2010006153207R00000X
IL036132144207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F14205Medicare UPIN