Healthcare Provider Details

I. General information

NPI: 1629016811
Provider Name (Legal Business Name): KATHY P SORGER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE MLC 5021
CINCINNATI OH
45229-3039
US

IV. Provider business mailing address

3333 BURNET AVE MLC 5021
CINCINNATI OH
45229-3039
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-4830
  • Fax: 513-636-7868
Mailing address:
  • Phone: 513-636-4830
  • Fax: 513-636-7868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number35.065057
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: