Healthcare Provider Details

I. General information

NPI: 1760907497
Provider Name (Legal Business Name): CARINE MARIE CATTIER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2017
Last Update Date: 01/17/2020
Certification Date: 01/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6701 N CHARLES ST
BALTIMORE MD
21204-6808
US

IV. Provider business mailing address

3801 STONE WAY N APT 318
SEATTLE WA
98103-8079
US

V. Phone/Fax

Practice location:
  • Phone: 443-849-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberC0006544
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA059165
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: