Provider Demographics
NPI:1699828780
Name:POWERS, KATHERINE ALICE (MD)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ALICE
Last Name:POWERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:198 LITTLETON RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WESTFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01886-3408
Mailing Address - Country:US
Mailing Address - Phone:979-323-0312
Mailing Address - Fax:978-323-0344
Practice Address - Street 1:161 JACKSON ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-2103
Practice Address - Country:US
Practice Address - Phone:978-937-9700
Practice Address - Fax:978-221-6728
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2024-01-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NH11358207P00000X
MA150291207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G36413Medicare UPIN
G36413Medicare UPIN