Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | D0007427 | MD |
NPI | 1053659177 |
---|---|
Provider Name | Dr. Clayton Louis Moravec JR. |
First Address | Baltimore, MD 21231-3352 |
Second Address | Baltimore, MD 21231-3352 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2013 |
Last Update Date | 24/01/2013 |