Provider Demographics
NPI:1124142211
Name:KNAUDT, PATRICIA RUTH (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:RUTH
Last Name:KNAUDT
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 1:547 KEISLER DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-9309
Mailing Address - Country:US
Mailing Address - Phone:919-851-3939
Mailing Address - Fax:
Practice Address - Street 1:547 KEISLER DR
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-9309
Practice Address - Country:US
Practice Address - Phone:919-851-3939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC97006192084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC131YJOtherBCBS IDENTIFIER