Individual
DR. KATHERYN ELLEN KERMODE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
379 DIXMYTH AVE, CINCINNATI, OH 45220
(513) 246-7000
(513) 246-7590
Mailing address
4685 FOREST AVE, CINCINNATI, OH 45212-3397
(513) 246-7000
(513) 246-7590
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35-086940
OH
208000000X
Pediatrics Physician
35-086940
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200537050
—
IN
05
—
2595884
—
OH
05
—
64114820
—
KY
Enumeration date
04/21/2006
Last updated
03/15/2019
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