Provider Demographics
NPI:1871618215
Name:CARRUTHERS, CATHERINE DOUGLAS (MD)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:DOUGLAS
Last Name:CARRUTHERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 TILLMAN DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-2071
Mailing Address - Country:US
Mailing Address - Phone:215-633-3456
Mailing Address - Fax:
Practice Address - Street 1:45 2ND STREET PIKE STE 100
Practice Address - Street 2:
Practice Address - City:SOUTHAMPTON
Practice Address - State:PA
Practice Address - Zip Code:18966-3829
Practice Address - Country:US
Practice Address - Phone:215-633-3456
Practice Address - Fax:215-396-3456
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4291932086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA112862Medicare PIN