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Individual

KATIE CALAWAY IMHOF

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3535 SOUTHERN BLVD, KETTERING, OH 45429-1221
(937) 436-4658
(937) 436-4984
Mailing address
20 PRESTIGE PLAZA DR, SUITE 100, MIAMISBURG, OH 45342-7303
(937) 436-4658
(937) 436-4984

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35.121503
OH
390200000X
Student in an Organized Health Care Education/Training Program
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
H207170
MEDICARE PTAN
OH
01
H215720
MEDICARE PTAN
OH
Enumeration date
04/26/2011
Last updated
08/09/2013
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