Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 35-068120 | OH |
NPI | 1013088418 |
---|---|
Provider Name | Joseph J Moellman |
First Address | Cincinnati, OH 45267-0001 |
Second Address | Cincinnati, OH 45267-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G39955 | (02) | OH |