Basic Information
| Provider Information | |||||||||
| NPI: | 1891172961 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | DESPOTES | ||||||||
| FirstName: | KATHERINE | ||||||||
| MiddleName: | ALEXANDRA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12304 SPRING MEADOW DR | ||||||||
| Address2: | |||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275179096 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9196490614 | ||||||||
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| Practice Location | |||||||||
| Address1: | CB# 7020, 130 MASON FARM ROAD 4TH FLOOR BIOINFORMATICS | ||||||||
| Address2: | |||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275997593 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9849745703 | ||||||||
| FaxNumber: | 9849745737 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/28/2015 | ||||||||
| LastUpdateDate: | 04/20/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/20/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 209604 | NC | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208000000X | 209604 | NC | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.