Provider Demographics
NPI:1366689598
Name:DIABETES ENDOCRINOLOGY OF CENTRAL OHIO INC
Entity Type:Organization
Organization Name:DIABETES ENDOCRINOLOGY OF CENTRAL OHIO INC
Other - Org Name:CHARLES M KATZ MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:M
Authorized Official - Last Name:KATZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-457-7746
Mailing Address - Street 1:941 CHATHAM LN
Mailing Address - Street 2:SUITE 206
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-2416
Mailing Address - Country:US
Mailing Address - Phone:614-457-7746
Mailing Address - Fax:
Practice Address - Street 1:941 CHATHAM LN
Practice Address - Street 2:SUITE 206
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-2416
Practice Address - Country:US
Practice Address - Phone:614-457-7746
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-09
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35032715207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty