Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 35044515 | OH |
NPI | 1003095472 |
---|---|
Provider Name | Mohammad A. Moayeri |
First Address | Garfield Hts, OH 44125-2964 |
Second Address | Garfield Hts, OH 44125-3928 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2007 |
Last Update Date | 16/03/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0507615 | (05) | OH |