Provider Demographics
NPI:1023059797
Name:GREIWE, CATHY A (MD)
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:A
Last Name:GREIWE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4885 OLENTANGY RIVER RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-1952
Mailing Address - Country:US
Mailing Address - Phone:614-268-6555
Mailing Address - Fax:614-457-5706
Practice Address - Street 1:4885 OLENTANGY RIVER RD
Practice Address - Street 2:SUITE 110
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-1952
Practice Address - Country:US
Practice Address - Phone:614-268-6555
Practice Address - Fax:614-457-5706
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-10
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35071119207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2112396Medicaid
OH2112396Medicaid
G76328Medicare UPIN