Individual
DR. KATHRYN MCGOVERN COLTERYAHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1351 RONALD REAGAN PKWY STE A, AVON, IN 46123-6764
(317) 217-2919
(317) 219-2916
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01070966A
IN
207R00000X
Internal Medicine Physician
MT195204
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201067620
—
IN
Enumeration date
06/21/2009
Last updated
01/06/2021
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