Provider Demographics
NPI:1194012534
Name:AHMADZADEH, KATIE (DO)
Entity type:Individual
Prefix:DR
First Name:KATIE
Middle Name:
Last Name:AHMADZADEH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2545 SCHOENERSVILLE ROAD
Mailing Address - Street 2:5TH FLOOR SOUTH
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017
Mailing Address - Country:US
Mailing Address - Phone:484-884-2888
Mailing Address - Fax:
Practice Address - Street 1:2545 SCHOENERSVILLE ROAD
Practice Address - Street 2:5TH FLOOR SOUTH
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017
Practice Address - Country:US
Practice Address - Phone:484-884-2888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-06
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT014190207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine