Healthcare Provider Details

I. General information

NPI: 1598937385
Provider Name (Legal Business Name): RICHARD L. CATTERLIN, D.O., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2008
Last Update Date: 04/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1360 N CANFIELD NILES RD
MINERAL RIDGE OH
44440-9600
US

IV. Provider business mailing address

1360 N CANFIELD NILES RD
MINERAL RIDGE OH
44440-9600
US

V. Phone/Fax

Practice location:
  • Phone: 330-652-6556
  • Fax: 330-652-6390
Mailing address:
  • Phone: 330-652-6556
  • Fax: 330-652-6390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34-003053C
License Number StateOH

VIII. Authorized Official

Name: DR. RICHARD L CATTERLIN
Title or Position: PHYSICIAN/PRESIDENT
Credential: D.O.
Phone: 330-652-6556