Provider Demographics
NPI:1205887312
Name:FURUYA, KATRYN N (MD)
Entity type:Individual
Prefix:DR
First Name:KATRYN
Middle Name:N
Last Name:FURUYA
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 1:600 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53792-0001
Mailing Address - Country:US
Mailing Address - Phone:608-890-9400
Mailing Address - Fax:
Practice Address - Street 1:600 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53792-0001
Practice Address - Country:US
Practice Address - Phone:608-890-9400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-13
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC100085292080P0206X
PAMD4246272080T0004X
WI717752080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
No2080T0004XAllopathic & Osteopathic PhysiciansPediatricsPediatric Transplant Hepatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101116765Medicaid
NJ143979Medicaid
MD4134745Medicaid
PA101116765Medicaid