Healthcare Provider Details

I. General information

NPI: 1568517506
Provider Name (Legal Business Name): KATHRYN LEE STEUER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHRYN LEE KNUTZEN MD

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 10/23/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 WEST MAIN STREET
BERRYVILLE VA
22611
US

IV. Provider business mailing address

13 WEST MAIN STREET
BERRYVILLE VA
22611
US

V. Phone/Fax

Practice location:
  • Phone: 540-955-0812
  • Fax: 540-955-0813
Mailing address:
  • Phone: 540-955-0812
  • Fax: 540-955-0813

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number0101236407
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: