Provider Demographics
NPI:1518154020
Name:SULKOWSKI, KATHRYN L (DO)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:L
Last Name:SULKOWSKI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:MISS
Other - First Name:KATHRYN
Other - Middle Name:L
Other - Last Name:HOLMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1517 ROCK SPRING RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:FOREST HILL
Mailing Address - State:MD
Mailing Address - Zip Code:21050-2818
Mailing Address - Country:US
Mailing Address - Phone:410-838-6358
Mailing Address - Fax:410-838-6750
Practice Address - Street 1:1517 ROCK SPRING RD
Practice Address - Street 2:SUITE C
Practice Address - City:FOREST HILL
Practice Address - State:MD
Practice Address - Zip Code:21050-2818
Practice Address - Country:US
Practice Address - Phone:410-838-6358
Practice Address - Fax:410-838-6750
Is Sole Proprietor?:No
Enumeration Date:2007-09-28
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MDH0078491207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program