Provider Demographics
NPI:1306815808
Name:CATA, CEFERINO J (MD)
Entity Type:Individual
Prefix:
First Name:CEFERINO
Middle Name:J
Last Name:CATA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3535 PENTAGON BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45431-1705
Mailing Address - Country:US
Mailing Address - Phone:937-757-9449
Mailing Address - Fax:937-702-4944
Practice Address - Street 1:3535 PENTAGON BLVD STE 330
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45431-1705
Practice Address - Country:US
Practice Address - Phone:937-757-9449
Practice Address - Fax:937-702-4944
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.059164207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0978876Medicaid
OH060023618OtherRAILROAD MEDICARE
OHH459720Medicare PIN
OH0978876Medicaid
OH0763151Medicare PIN