Provider Demographics
NPI:1336255223
Name:WHITFIELD, KATHERINE OPPEDAHL (MD)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:OPPEDAHL
Last Name:WHITFIELD
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 1:5221 PARAMOUNT PKWY STE 420
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-5491
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2226 NELSON HWY STE 200
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-9638
Practice Address - Country:US
Practice Address - Phone:984-974-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2016-01034207W00000X
IDM9683207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID807560500Medicaid
G63638Medicare UPIN
3331443Medicare ID - Type Unspecified
ID1134238Medicare PIN
ID0271500001Medicare NSC
ID807560500Medicaid