Provider Demographics
NPI:1366530511
Name:HERWIG, KATHRYN ELIZABETH (MD)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:ELIZABETH
Last Name:HERWIG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:KATHRYN
Other - Middle Name:ELIZABETH
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2713 DANTZLER DRIVE
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406
Mailing Address - Country:US
Mailing Address - Phone:843-764-1722
Mailing Address - Fax:843-764-1788
Practice Address - Street 1:2713 DANTZLER DR
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-9005
Practice Address - Country:US
Practice Address - Phone:843-764-1722
Practice Address - Fax:843-764-1788
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCBH9441394208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics