Provider Demographics
NPI:1437141934
Name:KATWA, GEETA (MD,)
Entity Type:Individual
Prefix:DR
First Name:GEETA
Middle Name:
Last Name:KATWA
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 1:1850 W ARLINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-5704
Mailing Address - Country:US
Mailing Address - Phone:252-752-6101
Mailing Address - Fax:252-752-6600
Practice Address - Street 1:717 ROSANNE DR STE 2
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28504-1502
Practice Address - Country:US
Practice Address - Phone:252-686-0932
Practice Address - Fax:252-686-0934
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-19
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200000845207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC127JROtherBCBS NC
NC89127JRMedicaid
NC660003182OtherRAILROAD MEDICARE
NC660003182OtherRAILROAD MEDICARE
NC2281199AMedicare ID - Type Unspecified