Basic Information
| Provider Information | |||||||||
| NPI: | 1811384647 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DONOWITZ | ||||||||
| FirstName: | KATHERINE | ||||||||
| MiddleName: | DAVILA WILLSON | ||||||||
| NamePrefix: | |||||||||
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| Credential: | MD | ||||||||
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| OtherLastName: | WILLSON | ||||||||
| OtherFirstName: | KATHERINE | ||||||||
| OtherMiddleName: | DAVILA | ||||||||
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| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | VCUHS GMEA | ||||||||
| Address2: | BOX 980257 | ||||||||
| City: | RICHMOND | ||||||||
| State: | VA | ||||||||
| PostalCode: | 232980257 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8048289783 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | VCUHS DEPT OF PEDIATRIC HOSPITAL MEDICINE, 980506 | ||||||||
| Address2: | 1000 E. BROAD STREET | ||||||||
| City: | RICHMOND | ||||||||
| State: | VA | ||||||||
| PostalCode: | 23298 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8046285881 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/20/2015 | ||||||||
| LastUpdateDate: | 07/05/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 0101264671 | VA | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.