Healthcare Provider Details

I. General information

NPI: 1205457793
Provider Name (Legal Business Name): KATHERINE MCGOWAN MILLER DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHERINE ELIZABETH TYLER MCGOWAN DO

II. Dates (important events)

Enumeration Date: 05/06/2020
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 W CORK ST UNIT 405
WINCHESTER VA
22601-3876
US

IV. Provider business mailing address

333 W CORK ST UNIT 405
WINCHESTER VA
22601-3876
US

V. Phone/Fax

Practice location:
  • Phone: 540-313-9200
  • Fax: 540-686-7287
Mailing address:
  • Phone: 540-313-9200
  • Fax: 540-686-7287

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOT020030
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0102210259
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS022272
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: