Provider Demographics
NPI:1174568935
Name:GOETZINGER, KATHERINE R (MD)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:R
Last Name:GOETZINGER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:250 W PRATT ST
Mailing Address - Street 2:SUITE 880
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-2423
Mailing Address - Country:US
Mailing Address - Phone:667-214-1302
Mailing Address - Fax:410-328-3379
Practice Address - Street 1:419 W REDWOOD ST
Practice Address - Street 2:SUITE 500
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1734
Practice Address - Country:US
Practice Address - Phone:667-214-1300
Practice Address - Fax:410-328-2648
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2016-05-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2010003207207V00000X
MDD0080165207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD101213400Medicaid
MD439064ZAN5Medicare PIN