Basic Information
| Provider Information | |||||||||
| NPI: | 1821095126 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KATZ | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9312 WINTON RD | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452313938 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5139313530 | ||||||||
| FaxNumber: | 5139312481 | ||||||||
| Practice Location | |||||||||
| Address1: | 9312 WINTON RD | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452313938 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5139313530 | ||||||||
| FaxNumber: | 5139312481 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2005 | ||||||||
| LastUpdateDate: | 11/02/2007 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | 03/20/2006 | ||||||||
| NPIReactivationDate: | 03/30/2006 | ||||||||
| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 35037752K | OH | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 0701197 | 01 | OH | UNITED HEALTHCARE | OTHER | 0580992 | 05 | OH | MEDICAID | 288036 | 01 | OH | AMERIGROUP | OTHER | 311575051036 | 01 | OH | CARESOURCE | OTHER | 990118 | 01 | OH | AETNA | OTHER |