Provider Demographics
NPI:1417029075
Name:DRS. MOYAL AND PETROFF, MDS, INC.
Entity Type:Organization
Organization Name:DRS. MOYAL AND PETROFF, MDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PEG
Authorized Official - Middle Name:
Authorized Official - Last Name:JAKAB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-461-6477
Mailing Address - Street 1:730 SOM CENTER RD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44143-2350
Mailing Address - Country:US
Mailing Address - Phone:440-461-6477
Mailing Address - Fax:440-461-1017
Practice Address - Street 1:730 SOM CENTER RD
Practice Address - Street 2:SUITE 230
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44143-2350
Practice Address - Country:US
Practice Address - Phone:440-461-6477
Practice Address - Fax:440-461-1017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty