Provider Demographics
NPI:1740570639
Name:GUST, KATHARINE BARTON (LAC, MAC)
Entity type:Individual
Prefix:
First Name:KATHARINE
Middle Name:BARTON
Last Name:GUST
Suffix:
Gender:F
Credentials:LAC, MAC
Other - Prefix:
Other - First Name:KATHARINE
Other - Middle Name:BARTON
Other - Last Name:GUST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5510 WOODLAWN RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210-1429
Mailing Address - Country:US
Mailing Address - Phone:443-825-5643
Mailing Address - Fax:
Practice Address - Street 1:314 WYNDHURST AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21210-2416
Practice Address - Country:US
Practice Address - Phone:443-825-5643
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-12
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01887171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist