MEDICARE: CATHERINE W GOULDIN M.D.

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	2080P0204X	Pediatric Emergency Medicine (Pediatrics) Physician	35-05-6531	OH

General Provider Information

NPI Number	:	1639106701
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHERINE W GOULDIN M.D.

Provider Business Mailing Address
First Line	:	7777 YANKEE RD
Second Line	:	ML 16022
City	:	LIBERTY TOWNSHIP
State	:	OH
Zip	:	45044-3500
Country	:	US
Telephone Number	:	513-803-9740
Fax Number	:	513-803-9564

Provider Business Practice Location Address
First Line	:	7777 YANKEE RD
Second Line	:	ML 16022
City	:	LIBERTY TOWNSHIP
State	:	OH
Zip	:	45044-3500
Country	:	US
Telephone Number	:	513-803-9740
Fax Number	:	513-803-9564

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2006
Last Update Date	:	02/25/2015

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Directions to “ CATHERINE W GOULDIN M.D.” Practice Location

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