Provider Demographics
NPI:1356600373
Name:MAIN, CATHERINE LYNN (MD)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:LYNN
Last Name:MAIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1030 NEW HOLLAND AVE
Mailing Address - Street 2:BLDG 12A SUITE 200
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-5690
Mailing Address - Country:US
Mailing Address - Phone:717-544-5028
Mailing Address - Fax:717-544-4296
Practice Address - Street 1:555 N DUKE ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2250
Practice Address - Country:US
Practice Address - Phone:717-544-7228
Practice Address - Fax:717-544-4149
Is Sole Proprietor?:No
Enumeration Date:2012-05-11
Last Update Date:2017-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT201526390200000X
PAMD454868207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program