Provider Demographics
NPI:1912389289
Name:KATERJI, NORA (MD)
Entity Type:Individual
Prefix:
First Name:NORA
Middle Name:
Last Name:KATERJI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22201 MOROSS RD # PB2
Mailing Address - Street 2:SUIT 70
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48236-2169
Mailing Address - Country:US
Mailing Address - Phone:313-343-3800
Mailing Address - Fax:313-343-4756
Practice Address - Street 1:1161 OMEGA DR
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740
Practice Address - Country:US
Practice Address - Phone:301-393-2600
Practice Address - Fax:301-393-2614
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-23
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301107437390200000X
MDD85246208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty