Healthcare Provider Details

I. General information

NPI: 1215968573
Provider Name (Legal Business Name): KATHI L MAKOROFF M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 02/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE ML 3008
CINCINNATI OH
45229-3026
US

IV. Provider business mailing address

3333 BURNET AVE ML 3008
CINCINNATI OH
45229-3026
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-7233
  • Fax: 513-636-0204
Mailing address:
  • Phone: 513-636-7233
  • Fax: 513-636-0204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number350-07-2650
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code2080C0008X
TaxonomyChild Abuse Pediatrics Physician
License Number35.072650
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: