Provider Demographics
NPI:1508048216
Name:HEALY, CATHERINE BIRDSALL
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:BIRDSALL
Last Name:HEALY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 78619
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28271-7037
Mailing Address - Country:US
Mailing Address - Phone:704-708-9943
Mailing Address - Fax:866-741-8485
Practice Address - Street 1:733 PLANTATION ESTATES DR
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-9116
Practice Address - Country:US
Practice Address - Phone:704-708-9943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-04
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC127213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC243059OtherCIGNA-MEDICARE