Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 01081828A | IN |
N | 207X00000X | Orthopaedic Surgeon | MT206872 | PA |
Y | 207XS0106X | Orthopaedic Hand Surgeon | 4351048779 | MI |
NPI | 1154736080 |
---|---|
Provider Name | Catarina D Gulledge |
First Address | Warren, MI 48093-2572 |
Second Address | Lafayette, IN 47905-8764 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2014 |
Last Update Date | 23/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3000026485 | (05) | IN |