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General NPI Number Information
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NPI Number | 1538160734
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Entity Type | Individual
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Provider Name | CATHY LYNN CANTOR MD
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Gender | Female
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Dates
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Enumeration Date | 08/10/2005
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Last Update Date | 04/06/2021
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Provider Practice Location Address
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Address Line | 12623 ECKEL JUNCTION RD STE 2600
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City | PERRYSBURG
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State | OH
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Zip | 43551-1304
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Country | US
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Telephone | 567-368-1700
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Fax | 567-368-1701
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Provider Business Mailing Address
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Address Line | 12623 ECKEL JUNCTION RD STE 2600
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City | PERRYSBURG
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State | OH
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Zip | 43551-1304
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Country | US
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Telephone |
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 35082449
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License Number State | OH
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