Provider Demographics
NPI:1528061470
Name:SCRUGGS, KATHERINE (MD)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:
Last Name:SCRUGGS
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 1:125 EMERYVILLE DR STE 110
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-5020
Mailing Address - Country:US
Mailing Address - Phone:412-854-7140
Mailing Address - Fax:412-854-7142
Practice Address - Street 1:125 EMERYVILLE DR STE 110
Practice Address - Street 2:
Practice Address - City:CRANBERRY TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:16066-5020
Practice Address - Country:US
Practice Address - Phone:412-854-7140
Practice Address - Fax:412-854-7142
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD 30036207V00000X
VA0101050787207V00000X
PAMD451403207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3819164Medicaid
VA010109710Medicaid
PA102907100Medicaid
TN3700592Medicare UPIN
TNP00114291Medicare PIN
PA347002Medicare PIN
VAMC10003Medicare UPIN
PA102907100Medicaid
VA010109710Medicaid
VAC06181Medicare UPIN
TN3819164Medicare ID - Type Unspecified
VA010109710Medicaid