Provider Demographics
NPI:1790702603
Name:DELL, KATHERINE M (MD)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:M
Last Name:DELL
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 1:9500 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9500 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-0001
Practice Address - Country:US
Practice Address - Phone:216-444-6123
Practice Address - Fax:216-448-6015
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-0745392080P0210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0211376OtherAETNA
OH363474OtherWELLCARE
OH734642OtherBUCKEYE
OH2070315Medicaid
OH000000027964OtherANTHEM
OH000000525903OtherANTHEM
OH2070315OtherBCMH
OH000000221426OtherUNISON
OH000000221426OtherUNISON
OH0211376OtherAETNA
OHDE0854053Medicare PIN