Provider Demographics
NPI:1710076799
Name:TAWNEY, KATHRYN (MD)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:TAWNEY
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 74090
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44194-4090
Mailing Address - Country:US
Mailing Address - Phone:440-720-3260
Mailing Address - Fax:440-720-3259
Practice Address - Street 1:5850 LANDERBROOK DR STE 105
Practice Address - Street 2:
Practice Address - City:MAYFIELD HTS
Practice Address - State:OH
Practice Address - Zip Code:44124-4054
Practice Address - Country:US
Practice Address - Phone:440-720-3260
Practice Address - Fax:440-720-3259
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35059551T207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E76469Medicare UPIN