Provider Demographics
NPI:1184600652
Name:TABB, CATHARINE J (MD)
Entity type:Individual
Prefix:DR
First Name:CATHARINE
Middle Name:J
Last Name:TABB
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 1:7325 SARATOGA HILLS DR NE
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44721-2724
Mailing Address - Country:US
Mailing Address - Phone:330-388-9428
Mailing Address - Fax:
Practice Address - Street 1:7325 SARATOGA HILLS DR NE
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44721-2724
Practice Address - Country:US
Practice Address - Phone:330-388-9428
Practice Address - Fax:330-388-9428
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-16
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH42588207QA0505X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH792083214OtherRAILROAD MEDICARE
OH0430528Medicaid
OH0476853Medicare ID - Type Unspecified
OH792083214OtherRAILROAD MEDICARE