Provider Demographics
NPI:1528025327
Name:KATZ, ROBERT L (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:L
Last Name:KATZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7580 AUBURN RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:CONCORD TWP
Mailing Address - State:OH
Mailing Address - Zip Code:44077-9615
Mailing Address - Country:US
Mailing Address - Phone:440-352-1474
Mailing Address - Fax:440-352-2662
Practice Address - Street 1:7580 AUBURN RD
Practice Address - Street 2:SUITE 103
Practice Address - City:CONCORD TWP
Practice Address - State:OH
Practice Address - Zip Code:44077-9615
Practice Address - Country:US
Practice Address - Phone:440-352-1474
Practice Address - Fax:440-352-2662
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2016-05-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35026815K207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0142358Medicaid
OHKA7351011Medicare PIN
OHC00659Medicare UPIN