Provider Demographics
NPI:1700871522
Name:OHMSTEDE, CATHERINE SAULS (MD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:SAULS
Last Name:OHMSTEDE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CATHERINE
Other - Middle Name:HARRIET
Other - Last Name:SAULS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-384-1866
Mailing Address - Fax:704-384-7867
Practice Address - Street 1:1315 EAST BLVD
Practice Address - Street 2:SUITE 280
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203-5793
Practice Address - Country:US
Practice Address - Phone:704-384-1866
Practice Address - Fax:704-384-1867
Is Sole Proprietor?:No
Enumeration Date:2005-09-19
Last Update Date:2020-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200600017208000000X
TNMD38488208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5905133Medicaid
SCN17006Medicaid
TN5440105Medicaid
NC5905133Medicaid