Provider Demographics
NPI:1255339511
Name:CIMAGLIA, CATHY A (DPM)
Entity type:Individual
Prefix:DR
First Name:CATHY
Middle Name:A
Last Name:CIMAGLIA
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 N 4TH ST STE 4
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21550-1371
Mailing Address - Country:US
Mailing Address - Phone:301-533-2940
Mailing Address - Fax:301-533-2942
Practice Address - Street 1:311 N 4TH ST STE 4
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:MD
Practice Address - Zip Code:21550-1371
Practice Address - Country:US
Practice Address - Phone:301-533-2940
Practice Address - Fax:301-533-2942
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01261213E00000X
WV00337213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0100089000Medicaid
MD614893-06, KFT9OtherBC/BS CAREFIRST OF MD
WA42-1586685-0001OtherMT ST BC/BS
MD616600800Medicaid
MD614893-06, KFT9OtherBC/BS CAREFIRST OF MD
MD4760610002Medicare NSC
WV4760610003Medicare NSC
MDP00039957Medicare ID - Type UnspecifiedRAIL ROAD MEDICARE
MD616600800Medicaid
MD669M, 182FMedicare ID - Type UnspecifiedMD MEDICARE