Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0202X | Pediatric Cardiologist | 01076061A | IN |
N | 2080P0202X | Pediatric Cardiologist | 26744 | WV |
Y | 2080P0202X | Pediatric Cardiologist | 35.097581 | OH |
N | 2080P0202X | Pediatric Cardiologist | 49071 | KY |
NPI | 1104090273 |
---|---|
Provider Name | Ryan Allen Moore |
First Address | Cincinnati, OH 45229 |
Second Address | Cincinnati, OH 45229-3026 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2008 |
Last Update Date | 05/07/2017 |