Provider Demographics
NPI:1063737773
Name:PERRY, KATHERINE S (MD)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:S
Last Name:PERRY
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4000 MITCHELLVILLE RD
Mailing Address - Street 2:SUITE A414
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-3104
Mailing Address - Country:US
Mailing Address - Phone:301-860-0985
Mailing Address - Fax:301-860-0978
Practice Address - Street 1:4000 MITCHELLVILLE RD
Practice Address - Street 2:SUITE A414
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-3104
Practice Address - Country:US
Practice Address - Phone:301-860-0985
Practice Address - Fax:301-860-0978
Is Sole Proprietor?:No
Enumeration Date:2010-04-06
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD79041207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology