Provider Demographics
NPI:1063580199
Name:CHIODO, CATHERINE (DPM)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:
Last Name:CHIODO
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1272 W MAIN ST
Mailing Address - Street 2:BUILDING #4
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-2004
Mailing Address - Country:US
Mailing Address - Phone:740-345-8800
Mailing Address - Fax:740-344-5829
Practice Address - Street 1:1272 W MAIN ST
Practice Address - Street 2:BUILDING #4
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-2004
Practice Address - Country:US
Practice Address - Phone:740-345-8800
Practice Address - Fax:740-344-5829
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2012-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2643213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0794305Medicaid
OHT98031Medicare UPIN
OHCH0669391Medicare ID - Type Unspecified