Provider Demographics
NPI:1891897690
Name:BOHME, CAROLINE J (MD)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:J
Last Name:BOHME
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 1:175 W GALBRAITH RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45216-1015
Mailing Address - Country:US
Mailing Address - Phone:513-418-5700
Mailing Address - Fax:513-418-5773
Practice Address - Street 1:175 W GALBRAITH RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45216-1015
Practice Address - Country:US
Practice Address - Phone:513-418-5700
Practice Address - Fax:513-418-5773
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35069678B207V00000X
KY37371207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200147840Medicaid
OH2203145Medicaid
KY64052376Medicaid
OH4271111Medicare PIN
OH2203145Medicaid
KY3316377Medicare PIN
KY0969455Medicare PIN
KY0690103Medicare PIN
IN200147840Medicaid
KY00182008Medicare PIN