Healthcare Provider Details

I. General information

NPI: 1538146550
Provider Name (Legal Business Name): KATHRYN ANN CAULFIELD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/30/2005
Last Update Date: 02/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2391 COURT DR SUITE 120
GASTONIA NC
28054-2196
US

IV. Provider business mailing address

2391 COURT DR SUITE 120
GASTONIA NC
28054-2196
US

V. Phone/Fax

Practice location:
  • Phone: 704-866-8976
  • Fax: 704-866-8680
Mailing address:
  • Phone: 704-866-8976
  • Fax: 704-866-8680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number9600398
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: