Healthcare Provider Details
I. General information
NPI: 1245286293
Provider Name (Legal Business Name): KATHERINE R KULA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/25/2006
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
61 THOMAS JOHNSON DR
FREDERICK MD
21702-4301
US
IV. Provider business mailing address
5801 POSTAL RD UNIT 81310
CLEVELAND OH
44181-2112
US
V. Phone/Fax
- Phone: 301-663-6171
- Fax: 301-695-4469
- Phone: 301-340-8339
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | 0101239195 |
| License Number State | VA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | D0103934 |
| License Number State | MD |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: