Provider Demographics
NPI:1023351798
Name:CARMICHAEL, KATHERINE CHRISTINE (DO)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:CHRISTINE
Last Name:CARMICHAEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:CHRISTINE
Other - Last Name:SCHWARTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5133 RIDGE RD
Mailing Address - Street 2:STE 1
Mailing Address - City:WADSWORTH
Mailing Address - State:OH
Mailing Address - Zip Code:44281-8077
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5133 RIDGE RD
Practice Address - Street 2:STE 1
Practice Address - City:WADSWORTH
Practice Address - State:OH
Practice Address - Zip Code:44281-8077
Practice Address - Country:US
Practice Address - Phone:330-239-4455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-01
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.012015207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program