Healthcare Provider Details

I. General information

NPI: 1306820493
Provider Name (Legal Business Name): MARGUERITE MARYANNA KATCHEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

Provider Other Name: MARGUERITE MARYANNA BLYTHE MD

II. Dates (important events)

Enumeration Date: 12/01/2005
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4903 VINE ST
CINCINNATI OH
45217-1252
US

IV. Provider business mailing address

4903 VINE ST
CINCINNATI OH
45217-1252
US

V. Phone/Fax

Practice location:
  • Phone: 513-421-2900
  • Fax: 513-345-3045
Mailing address:
  • Phone: 513-421-2900
  • Fax: 513-345-3045

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number35052570
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: