Provider Demographics
NPI:1548202815
Name:CATANESE, MARLENE A (MD)
Entity Type:Individual
Prefix:DR
First Name:MARLENE
Middle Name:A
Last Name:CATANESE
Suffix:
Gender:F
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:PO BOX 308
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:TN
Mailing Address - Zip Code:37307-0308
Mailing Address - Country:US
Mailing Address - Phone:423-338-8995
Mailing Address - Fax:423-338-8996
Practice Address - Street 1:1420 FRITZ STREET
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37323-1420
Practice Address - Country:US
Practice Address - Phone:423-338-8995
Practice Address - Fax:423-338-8996
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN19348207P00000X
TNMD019348207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNE57144Medicare UPIN