Basic Information
| Provider Information | |||||||||
| NPI: | 1306057609 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MILLER | ||||||||
| FirstName: | KATHERINE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4440 RED BANK RD | ||||||||
| Address2: | SUITE 210 | ||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452272176 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5132720313 | ||||||||
| FaxNumber: | 5132720316 | ||||||||
| Practice Location | |||||||||
| Address1: | 4440 RED BANK RD | ||||||||
| Address2: | SUITE 210 | ||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452272176 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5132720313 | ||||||||
| FaxNumber: | 5132720316 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/25/2007 | ||||||||
| LastUpdateDate: | 10/30/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/30/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RE0101X | 35.090839 | OH | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism |
ID Information
| ID | Type | State | Issuer | Description | 2996781 | 05 | OH | MEDICAID | 7100099660 | 05 | KY | MEDICAID |