1801014238 NPI number — DR. KATHARINE ROXANNE GRAWE M.D.

Table of content: DR. KATHARINE ROXANNE GRAWE M.D. (NPI 1801014238)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801014238 NPI number — DR. KATHARINE ROXANNE GRAWE M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GRAWE
Provider First Name:
KATHARINE
Provider Middle Name:
ROXANNE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
TAYLOR
Provider Other First Name:
KATHARINE
Provider Other Middle Name:
ROXANNE
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1801014238
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/15/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3982 POWELL RD. SUITE 127
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
POWELL
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43065
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-764-7699
Provider Business Mailing Address Fax Number:
614-764-2664

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10330 SAWMILL PKWY
Provider Second Line Business Practice Location Address:
SUITE 450
Provider Business Practice Location Address City Name:
POWELL
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43065-7790
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-764-7699
Provider Business Practice Location Address Fax Number:
614-764-2664
Provider Enumeration Date:
04/23/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2086S0122X , with the licence number:  57-010817 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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