Provider Demographics
NPI:1871575126
Name:EINHAUS, KATHRYN B (MD)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:B
Last Name:EINHAUS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10215 AUBURN PARK DR
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46825-2387
Mailing Address - Country:US
Mailing Address - Phone:260-490-2229
Mailing Address - Fax:260-490-3807
Practice Address - Street 1:10215 AUBURN PARK DR
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46825-2387
Practice Address - Country:US
Practice Address - Phone:260-490-2229
Practice Address - Fax:260-490-3807
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01039523207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7617210Medicaid
IN160054729OtherRAILROAD MEDICARE
IN100102680Medicaid
E92793Medicare UPIN
NC7617210Medicaid