Provider Demographics
NPI:1538485032
Name:SECHRIST, CATHERINE WILLIFORD (MD)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:WILLIFORD
Last Name:SECHRIST
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:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1806 S HAWTHORNE RD STE 100
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-4014
Practice Address - Country:US
Practice Address - Phone:336-718-2560
Practice Address - Fax:336-718-2569
Is Sole Proprietor?:No
Enumeration Date:2010-04-09
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC164443208000000X
NC2016-01056208000000X, 2080P0202X
SC355182080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1538485032Medicaid
SC355181Medicaid
NC1538485032Medicaid
SC355181Medicaid