Provider Demographics
NPI:1568997534
Name:FIDELER, KATHRYN (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:
Last Name:FIDELER
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2445 ARMY NAVY DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206-2988
Mailing Address - Country:US
Mailing Address - Phone:703-892-6500
Mailing Address - Fax:
Practice Address - Street 1:4302 ALTON ROAD SUITE 220
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2988
Practice Address - Country:US
Practice Address - Phone:305-674-2090
Practice Address - Fax:305-674-2093
Is Sole Proprietor?:No
Enumeration Date:2017-04-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101275883207X00000X
390200000X
FLME162547207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program