Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | MD026332E | PA |
NPI | 1063420636 |
---|---|
Provider Name | Michael Moritz |
First Address | Philadelphia, PA 19178-3311 |
Second Address | Allentown, PA 18103-6224 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2006 |
Last Update Date | 24/11/2015 |