Provider Demographics
NPI:1013980887
Name:GARES, KATHIE ANN (MD)
Entity Type:Individual
Prefix:
First Name:KATHIE
Middle Name:ANN
Last Name:GARES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6 STIRLING CT
Mailing Address - Street 2:
Mailing Address - City:CHESTERBROOK
Mailing Address - State:PA
Mailing Address - Zip Code:19087-5703
Mailing Address - Country:US
Mailing Address - Phone:610-296-9516
Mailing Address - Fax:215-580-3726
Practice Address - Street 1:1234 MARKET ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-3721
Practice Address - Country:US
Practice Address - Phone:215-580-7128
Practice Address - Fax:215-580-3726
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD021692-E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine