Provider Demographics
NPI:1285623637
Name:MUZINA, KATHRYN SNOW (MD)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:SNOW
Last Name:MUZINA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:REBECCA
Other - Last Name:SNOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:34500 CHARDON RD
Mailing Address - Street 2:
Mailing Address - City:WILLOUGHBY HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44094-8238
Mailing Address - Country:US
Mailing Address - Phone:440-516-0275
Mailing Address - Fax:440-516-0298
Practice Address - Street 1:2785 SOM CENTER RD
Practice Address - Street 2:
Practice Address - City:WILLOUGHBY HILLS
Practice Address - State:OH
Practice Address - Zip Code:44094-6501
Practice Address - Country:US
Practice Address - Phone:440-602-8601
Practice Address - Fax:440-602-8619
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350678382084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2032795Medicaid
OH7316232Medicare PIN
OHMU7288541Medicare ID - Type Unspecified
G65308Medicare UPIN