Provider Demographics
NPI:1639361710
Name:STOPKO, KATARINA (MD)
Entity Type:Individual
Prefix:
First Name:KATARINA
Middle Name:
Last Name:STOPKO
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 1:24701 EUCLID AVE
Mailing Address - Street 2:THIRD FLOOR BILLING SERVICES
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1714
Mailing Address - Country:US
Mailing Address - Phone:440-243-8040
Mailing Address - Fax:440-243-1170
Practice Address - Street 1:18660 BAGLEY RD
Practice Address - Street 2:STE 407
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44130-3483
Practice Address - Country:US
Practice Address - Phone:440-243-8040
Practice Address - Fax:440-243-1170
Is Sole Proprietor?:No
Enumeration Date:2007-08-13
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA063135208000000X
OH35-121622208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0086756Medicaid