Healthcare Provider Details
I. General information
NPI: 1326797937
Provider Name (Legal Business Name): MAREN KATHLEEN OSTERHOLT DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/21/2022
Last Update Date: 03/21/2022
Certification Date: 03/21/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
375 DIXMYTH AVE
CINCINNATI OH
45220-2475
US
IV. Provider business mailing address
214 E ARMOUR BLVD APT 516
KANSAS CITY MO
64111-1249
US
V. Phone/Fax
- Phone: 513-862-2563
- Fax: 513-751-8638
- Phone: 314-604-1008
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: