Provider Demographics
NPI:1851340186
Name:KATTERJOHN, KARL RADLEY (PA)
Entity Type:Individual
Prefix:MR
First Name:KARL
Middle Name:RADLEY
Last Name:KATTERJOHN
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9039 SLIGO CREEK PKWY
Mailing Address - Street 2:APT 1401
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-3301
Mailing Address - Country:US
Mailing Address - Phone:301-792-4484
Mailing Address - Fax:
Practice Address - Street 1:9039 SLIGO CREEK PKWY
Practice Address - Street 2:APT 1401
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-3301
Practice Address - Country:US
Practice Address - Phone:301-792-4484
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0000435363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical