Healthcare Provider Details

I. General information

NPI: 1346582244
Provider Name (Legal Business Name): KATHERINE MAUREEN CARLIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2013
Last Update Date: 08/20/2021
Certification Date: 07/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

US NAVAL HOSPITAL OKINAWA CAMP FOSTER
FPO AP
96362
US

IV. Provider business mailing address

PSC 482 BOX 3096
FPO AP
96362-0031
US

V. Phone/Fax

Practice location:
  • Phone: 315-646-7488
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101256752
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number0101256753
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number0101256752
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: