Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 11013110A | IN |
NPI | 1083872022 |
---|---|
Provider Name | Aaron Moberly |
First Address | Columbus, OH 43212-3153 |
Second Address | Columbus, OH 43212-3153 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2008 |
Last Update Date | 18/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0081546 | (05) | OH |