Provider Demographics
NPI:1447245576
Name:CATTERLIN, GLORIA PERRY (DO)
Entity Type:Individual
Prefix:DR
First Name:GLORIA
Middle Name:PERRY
Last Name:CATTERLIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1360 N CANFIELD NILES RD
Mailing Address - Street 2:
Mailing Address - City:MINERAL RIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:44440-9600
Mailing Address - Country:US
Mailing Address - Phone:330-652-6556
Mailing Address - Fax:330-652-6390
Practice Address - Street 1:1360 N CANFIELD NILES RD
Practice Address - Street 2:
Practice Address - City:MINERAL RIDGE
Practice Address - State:OH
Practice Address - Zip Code:44440-9600
Practice Address - Country:US
Practice Address - Phone:330-652-6556
Practice Address - Fax:330-652-6390
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-00-3602207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0637930Medicaid
OHH133911OtherMEDICARE PTAN
OHE00691Medicare UPIN