Provider Demographics
NPI:1851725105
Name:CENTRAL OHIO THORACIC AND CARDIOVASCULAR SURGERY, INC.
Entity Type:Organization
Organization Name:CENTRAL OHIO THORACIC AND CARDIOVASCULAR SURGERY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:CATTANEO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-889-9564
Mailing Address - Street 1:5281 LOCUST HILL LN
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-4324
Mailing Address - Country:US
Mailing Address - Phone:614-889-9564
Mailing Address - Fax:614-889-9267
Practice Address - Street 1:5281 LOCUST HILL LN
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-4324
Practice Address - Country:US
Practice Address - Phone:614-889-9564
Practice Address - Fax:614-889-9267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-22
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.032311208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0229845Medicaid
OH037255Medicare UPIN