Healthcare Provider Details
I. General information
NPI: 1700871522
Provider Name (Legal Business Name): CATHERINE SAULS OHMSTEDE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/19/2005
Last Update Date: 10/25/2020
Certification Date: 09/06/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1315 EAST BLVD SUITE 280
CHARLOTTE NC
28203-5793
US
IV. Provider business mailing address
PO BOX 60447
CHARLOTTE NC
28260-0447
US
V. Phone/Fax
- Phone: 704-384-1866
- Fax: 704-384-1867
- Phone: 704-384-1866
- Fax: 704-384-7867
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 200600017 |
| License Number State | NC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: