Provider Demographics
NPI:1609885706
Name:BUEGE, KATHRYNE L (DO)
Entity Type:Individual
Prefix:
First Name:KATHRYNE
Middle Name:L
Last Name:BUEGE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3330 PEACH ST STE 106B
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16508-2771
Mailing Address - Country:US
Mailing Address - Phone:814-877-5570
Mailing Address - Fax:814-877-5571
Practice Address - Street 1:3330 PEACH ST STE 106B
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16508-2771
Practice Address - Country:US
Practice Address - Phone:814-877-5570
Practice Address - Fax:814-877-5571
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2019-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS013511207Q00000X
NY259427207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1902577OtherHIGHMARK
PA1902577OtherHIGHMARK