Basic Information
| Provider Information | |||||||||
| NPI: | 1154330744 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KATCHER | ||||||||
| FirstName: | JERALD | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 20800 HARVARD RD | ||||||||
| Address2: | 2ND FLOOR | ||||||||
| City: | HIGHLAND HILLS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441227249 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 11100 EUCLID AVE | ||||||||
| Address2: | |||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441061716 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2168443103 | ||||||||
| FaxNumber: | 4404491555 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2006 | ||||||||
| LastUpdateDate: | 12/24/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/24/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0001X | 35-072459 | OH | Y | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology |
ID Information
| ID | Type | State | Issuer | Description | P00449242 | 01 | OH | RAILROAD MEDICARE | OTHER | 000000224287 | 01 | OH | UNISON | OTHER | 2163073 | 05 | OH | MEDICAID | 000000529629 | 01 | OH | ANTHEM | OTHER | 746025 | 01 | OH | BUCKEYE | OTHER | 920006088 | 01 | OH | RAILROAD MEDICARE | OTHER | 363683 | 01 | OH | WELLCARE | OTHER | 000000195770 | 01 | OH | ANTHEM | OTHER | 2498125 | 01 | OH | AETNA | OTHER |