Healthcare Provider Details

I. General information

NPI: 1568812782
Provider Name (Legal Business Name): KATHARINE EMILY CALDWELL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2016
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 COURTENAY DRIVE MSC 29
CHARLESTON SC
29425-0001
US

IV. Provider business mailing address

PO BOX 7412011
CHICAGO IL
60674-2011
US

V. Phone/Fax

Practice location:
  • Phone: 843-985-4411
  • Fax:
Mailing address:
  • Phone: 314-747-0410
  • Fax: 877-991-8954

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number97578
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: