Provider Demographics
NPI:1821389743
Name:MODISETT, KATHARINE LYONS (MD)
Entity Type:Individual
Prefix:
First Name:KATHARINE
Middle Name:LYONS
Last Name:MODISETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 IRVING ST NW
Mailing Address - Street 2:DEPARTMENT OF PULMONARY DISEASE/CRITICAL CARE MEDICINE
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-3017
Mailing Address - Country:US
Mailing Address - Phone:202-877-7856
Mailing Address - Fax:202-877-6130
Practice Address - Street 1:110 IRVING ST NW
Practice Address - Street 2:DEPARTMENT OF PULMONARY DISEASE/CRITICAL CARE MEDICINE
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-3017
Practice Address - Country:US
Practice Address - Phone:202-877-7856
Practice Address - Fax:202-877-6130
Is Sole Proprietor?:No
Enumeration Date:2011-04-26
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DCMD042439207RC0200X
NC172912207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine