Provider Demographics
NPI:1568402584
Name:WERNER, KATHLEEN T (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:T
Last Name:WERNER
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 1:5769 SALTSBURG RD
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:PA
Mailing Address - Zip Code:15147-3211
Mailing Address - Country:US
Mailing Address - Phone:412-793-8870
Mailing Address - Fax:412-793-9290
Practice Address - Street 1:5769 SALTSBURG RD
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:PA
Practice Address - Zip Code:15147-3211
Practice Address - Country:US
Practice Address - Phone:412-793-8870
Practice Address - Fax:412-793-9290
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD042201L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA683247OtherHIGHMARK
PA0012625820001Medicaid
PA0012625820001Medicaid
PA683247Medicare ID - Type Unspecified