Provider Demographics
NPI:1477553378
Name:SMITH, CATHERINE S (MD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:S
Last Name:SMITH
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 1:401 ADAMS AVE
Mailing Address - Street 2:SUITE 306
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18510-2025
Mailing Address - Country:US
Mailing Address - Phone:570-963-9470
Mailing Address - Fax:570-963-9471
Practice Address - Street 1:401 ADAMS AVE
Practice Address - Street 2:SUITE 306
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18510-2025
Practice Address - Country:US
Practice Address - Phone:570-963-9470
Practice Address - Fax:570-963-9471
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-21
Last Update Date:2007-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-037808-E207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0071010440002Medicaid
PAME04113831516OtherNONE PROVIDED
NY161241OtherNONE PROVIDED
PASM465743Medicare PIN
PAME04113831516OtherNONE PROVIDED