Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 34003505 | OH |
NPI | 1174588180 |
---|---|
Provider Name | Dr. Daniel Neil Moretta |
First Address | Massillon, OH 44646-3616 |
Second Address | Massillon, OH 44646-3616 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2006 |
Last Update Date | 11/05/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0530956 | (05) | OH |
A15398 | (02) | OH |