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General NPI Number Information
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NPI Number | 1104455310
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Entity Type | Individual
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Provider Name | KATHERINE SHEVELSON MD
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Gender | Female
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Dates
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Enumeration Date | 04/08/2020
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 905 OLD DILEY RD
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City | PICKERINGTON
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State | OH
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Zip | 43147-2113
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Country | US
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Telephone | 614-864-3222
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Fax | 614-863-7388
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Provider Business Mailing Address
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Address Line | 1021 COUNTRY CLUB RD UNIT A
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City | COLUMBUS
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State | OH
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Zip | 43213-2484
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Country | US
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Telephone | 614-501-7337
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Fax | 614-434-2701
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 57.250015
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 35.148242
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License Number State | OH
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