Provider Demographics
NPI:1720387392
Name:CATALINE, PHILIP ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:ROBERT
Last Name:CATALINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 W 21ST ST STE 1
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44052-4754
Mailing Address - Country:US
Mailing Address - Phone:440-233-0138
Mailing Address - Fax:440-233-1051
Practice Address - Street 1:221 W 21ST ST STE 1
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44052-4754
Practice Address - Country:US
Practice Address - Phone:440-233-0138
Practice Address - Fax:440-233-1051
Is Sole Proprietor?:No
Enumeration Date:2011-03-22
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.122641207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0096827Medicaid