MEDICARE: CENTRAL OHIO THORACIC & CARDIOVASCULAR SURGERY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician

General Provider Information

NPI Number	:	1316047343
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL OHIO THORACIC & CARDIOVASCULAR SURGERY

Provider Business Mailing Address
First Line	:	PO BOX 13149
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43213-0149
Country	:	US
Telephone Number	:	614-235-2326
Fax Number	:	614-235-5194

Provider Business Practice Location Address
First Line	:	4236 E BROAD ST
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43213-1279
Country	:	US
Telephone Number	:	614-235-2326
Fax Number	:	614-235-5194

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. STEPHEN M CATTANEO
Credential	:	MD
Telephone Number	:	614-235-2326

Provider Enumeration Date	:	09/22/2006
Last Update Date	:	08/22/2020

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