Provider Demographics
NPI:1124181573
Name:VITOSH, CATHERINE E (MD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:E
Last Name:VITOSH
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 1:606 MULBERRY RD
Mailing Address - Street 2:
Mailing Address - City:DERBY
Mailing Address - State:KS
Mailing Address - Zip Code:67037-3532
Mailing Address - Country:US
Mailing Address - Phone:316-788-3787
Mailing Address - Fax:316-788-2618
Practice Address - Street 1:606 MULBERRY RD
Practice Address - Street 2:
Practice Address - City:DERBY
Practice Address - State:KS
Practice Address - Zip Code:67037-3532
Practice Address - Country:US
Practice Address - Phone:316-788-3787
Practice Address - Fax:316-788-2618
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0428404207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSP00099501OtherRAILROAD MEDICARE
GAHO1317Medicare UPIN
KSP00099501OtherRAILROAD MEDICARE