MEDICARE: KATHIE ANN GARES M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MD021692-E	PA

General Provider Information

NPI Number	:	1013980887
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHIE ANN GARES M.D.

Provider Business Mailing Address
First Line	:	6 STIRLING CT
Second Line	:
City	:	CHESTERBROOK
State	:	PA
Zip	:	19087-5703
Country	:	US
Telephone Number	:	610-296-9516
Fax Number	:	215-580-3726

Provider Business Practice Location Address
First Line	:	1234 MARKET ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-3721
Country	:	US
Telephone Number	:	215-580-7128
Fax Number	:	215-580-3726

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/10/2006
Last Update Date	:	07/08/2007

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