Healthcare Provider Details

I. General information

NPI: 1225263999
Provider Name (Legal Business Name): KATE GROGAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2009
Last Update Date: 06/09/2022
Certification Date: 06/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3535 OLENTANGY RIVER RD
COLUMBUS OH
43214-3908
US

IV. Provider business mailing address

4619 KENNY RD CORPATH - CRED
COLUMBUS OH
43220-2779
US

V. Phone/Fax

Practice location:
  • Phone: 614-566-4945
  • Fax:
Mailing address:
  • Phone: 614-457-8180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZB0001X
TaxonomyBlood Banking & Transfusion Medicine Physician
License Number35.131575
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number35.131575
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: