Provider Demographics
NPI:1306820493
Name:KATCHEN, MARGUERITE MARYANNA (MD)
Entity Type:Individual
Prefix:
First Name:MARGUERITE
Middle Name:MARYANNA
Last Name:KATCHEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARGUERITE
Other - Middle Name:MARYANNA
Other - Last Name:BLYTHE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:4903 VINE ST
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45217-1252
Mailing Address - Country:US
Mailing Address - Phone:513-421-2900
Mailing Address - Fax:513-345-3045
Practice Address - Street 1:4903 VINE ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45217-1252
Practice Address - Country:US
Practice Address - Phone:513-421-2900
Practice Address - Fax:513-345-3045
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350525702084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0671161Medicaid
BL0642804Medicare ID - Type Unspecified
E54215Medicare UPIN