Provider Demographics
NPI:1013930486
Name:WENSTROM, KATHARINE D (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHARINE
Middle Name:D
Last Name:WENSTROM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 DUDLEY ST FL 3
Mailing Address - Street 2:WOMEN & INFANTS HOSPITAL OF RHODE ISLAND/MFM DIVISION
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02905-2401
Mailing Address - Country:US
Mailing Address - Phone:401-274-1122
Mailing Address - Fax:401-453-7622
Practice Address - Street 1:101 DUDLEY STREET, 3RD FLOOR
Practice Address - Street 2:WOMEN & INFANTS HOSPITAL OF RHODE ISLAND/MFM DIVISION
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905
Practice Address - Country:US
Practice Address - Phone:401-274-1122
Practice Address - Fax:401-453-7622
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL16316207VM0101X
TNMD0000041656207VM0101X
RIMD13064207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009951545Medicaid
AL051518084OtherBLUE CROSS
AL051524560OtherBLUE CROSS
AL009934822Medicaid
AL009951535Medicaid
AL009970035Medicaid
AL051521051OtherBLUE CROSS
AL000093717OtherBLUE CROSS
AL009951565Medicaid
AL009951595Medicaid
AL009951575Medicaid
AL009951585Medicaid
AL051526560OtherBLUE CROSS
AL009971425Medicaid
AL000084540OtherBLUE CROSS
AL000084540Medicaid
AL009936035Medicaid
AL051524558OtherBLUE CROSS
AL009951555Medicaid
AL009971115Medicaid