Healthcare Provider Details

I. General information

NPI: 1922272293
Provider Name (Legal Business Name): KATE ELIZABETH BERZ DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2008
Last Update Date: 06/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE ML 10001
CINCINNATI OH
45229
US

IV. Provider business mailing address

3333 BURNET AVE ML 10001
CINCINNATI OH
45229
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-4366
  • Fax: 513-636-0516
Mailing address:
  • Phone: 513-636-4366
  • Fax: 513-636-0516

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080S0010X
TaxonomyPediatric Sports Medicine Physician
License Number34.010305
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: