Provider Demographics
NPI:1013042456
Name:JOSEPH J. MORAVEC, M.D., INC.
Entity Type:Organization
Organization Name:JOSEPH J. MORAVEC, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:J
Authorized Official - Last Name:MORAVEC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-772-2442
Mailing Address - Street 1:1130 CONGRESS AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45246-4484
Mailing Address - Country:US
Mailing Address - Phone:513-772-2442
Mailing Address - Fax:513-722-2844
Practice Address - Street 1:1130 CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45246-4484
Practice Address - Country:US
Practice Address - Phone:513-772-2442
Practice Address - Fax:513-722-2844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH118 0025AZ261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0384301Medicaid
OH0384301Medicaid