Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 2301 009712 | MI |
N | 111N00000X | Chiropractor | 4650-012 | WI |
N | 111N00000X | Chiropractor | 5424 | MN |
Y | 111N00000X | Chiropractor | DC010283 | PA |
N | 111NN0400X | Neurology | 4113 | OH |
NPI | 1336457993 |
---|---|
Provider Name | Dr. Stephan Moje |
First Address | Cincinnati, OH 45227-4726 |
Second Address | Cincinnati, OH 45231-4837 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2010 |
Last Update Date | 19/09/2017 |