Provider Demographics
NPI:1588026025
Name:GREENFIELD, KATHARINE MARIE (MD)
Entity Type:Individual
Prefix:
First Name:KATHARINE
Middle Name:MARIE
Last Name:GREENFIELD
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 1:2651 WINDSOR ST
Mailing Address - Street 2:
Mailing Address - City:SUN PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53590-9825
Mailing Address - Country:US
Mailing Address - Phone:608-837-2206
Mailing Address - Fax:608-837-9752
Practice Address - Street 1:2651 WINDSOR ST
Practice Address - Street 2:
Practice Address - City:SUN PRAIRIE
Practice Address - State:WI
Practice Address - Zip Code:53590-9825
Practice Address - Country:US
Practice Address - Phone:608-837-2206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-23
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK141982207Q00000X
WI68311-20207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine