Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 35079949 | OH |
NPI | 1033493366 |
---|---|
Provider Name | Heidi Moawad |
First Address | Brecksville, OH 44141-1523 |
Second Address | Brecksville, OH 44141-1523 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2011 |
Last Update Date | 05/10/2011 |