Provider Demographics
NPI:1851871313
Name:SLUSARZ, KATHERINE MARIE (PA)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:MARIE
Last Name:SLUSARZ
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:836 E. 65TH STREET
Mailing Address - Street 2:SUITE 22
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405
Mailing Address - Country:US
Mailing Address - Phone:912-819-7878
Mailing Address - Fax:912-819-3320
Practice Address - Street 1:11700 MERCY BLVD
Practice Address - Street 2:PLAZA D, BLDG. 1, SUITE A
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31419
Practice Address - Country:US
Practice Address - Phone:912-819-0500
Practice Address - Fax:912-819-0501
Is Sole Proprietor?:No
Enumeration Date:2018-08-15
Last Update Date:2020-12-02
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Provider Licenses
StateLicense IDTaxonomies
MAPA6724363A00000X
GA10062363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant