Provider Demographics
NPI:1679555668
Name:DOUGLASS, KATHERINE ANNE (MD)
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:ANNE
Last Name:DOUGLASS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2150 PENNSYLVANIA AVE NW
Mailing Address - Street 2:FLOOR 2B BURNS BLDG
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-3201
Mailing Address - Country:US
Mailing Address - Phone:202-741-2911
Mailing Address - Fax:202-741-2921
Practice Address - Street 1:8901 WISCONSIN AVE
Practice Address - Street 2:BETHESDA NAVAL MEDICAL CENTER
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-0001
Practice Address - Country:US
Practice Address - Phone:301-295-4810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-16
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDMDD0063062207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine