Provider Demographics
NPI:1508835968
Name:HARRISON, KATHARINE S (MD)
Entity Type:Individual
Prefix:
First Name:KATHARINE
Middle Name:S
Last Name:HARRISON
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 1:9105 FRANKLIN SQUARE DR
Mailing Address - Street 2:SUITE 309
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-3930
Mailing Address - Country:US
Mailing Address - Phone:443-777-8300
Mailing Address - Fax:
Practice Address - Street 1:9105 FRANKLIN SQUARE DR
Practice Address - Street 2:SUITE 309
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-3930
Practice Address - Country:US
Practice Address - Phone:443-777-8300
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0035712207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F70526Medicare UPIN