Provider Demographics
NPI:1821095126
Name:KATZ, MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:KATZ
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 1:9312 WINTON RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-3938
Mailing Address - Country:US
Mailing Address - Phone:513-931-3530
Mailing Address - Fax:513-931-2481
Practice Address - Street 1:9312 WINTON RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-3938
Practice Address - Country:US
Practice Address - Phone:513-931-3530
Practice Address - Fax:513-931-2481
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2007-11-02
Deactivation Date:2006-03-20
Deactivation Code:
Reactivation Date:2006-03-30
Provider Licenses
StateLicense IDTaxonomies
OH35037752K207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0701197OtherUNITED HEALTHCARE
OH0580992Medicaid
OH288036OtherAMERIGROUP
OH311575051036OtherCARESOURCE
OH990118OtherAETNA
OH311575051036OtherCARESOURCE
OH990118OtherAETNA
OHKA0436554Medicare PIN