Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 35021342M | OH |
N | 207ND0101X | MOHS-Micrographic Surgeon | 35021342M | OH |
NPI | 1154482107 |
---|---|
Provider Name | Dr. Richard S Moraites |
First Address | Cincinnati, OH 45236-4201 |
Second Address | Cincinnati, OH 45236-4201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2006 |
Last Update Date | 21/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6126105 | (05) | OH |
A70052 | (02) | OH |