Provider Demographics
NPI:1851508196
Name:GREER, KATARINA BRENKUSOVA
Entity Type:Individual
Prefix:DR
First Name:KATARINA
Middle Name:BRENKUSOVA
Last Name:GREER
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:KATARINA
Other - Middle Name:
Other - Last Name:BRENKUSOVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:24701 EUCLID AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1714
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11100 EUCLID AVE # WRN5066
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1716
Practice Address - Country:US
Practice Address - Phone:216-844-7344
Practice Address - Fax:216-983-0347
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.090058207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2805049Medicaid
OH35.090058OtherSTATE LICENCE
OH2805049Medicaid