Provider Demographics
NPI:1477728517
Name:NADUVIL VALAPPIL, AHSAN MOOSA (MD)
Entity Type:Individual
Prefix:
First Name:AHSAN MOOSA
Middle Name:
Last Name:NADUVIL VALAPPIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2515 KEMPER RD
Mailing Address - Street 2:APT 209
Mailing Address - City:SHAKER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44120-5500
Mailing Address - Country:US
Mailing Address - Phone:216-921-1254
Mailing Address - Fax:216-445-9139
Practice Address - Street 1:2680 N MORELAND BLVD
Practice Address - Street 2:APT 605
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44120-1472
Practice Address - Country:US
Practice Address - Phone:216-921-1254
Practice Address - Fax:216-445-9139
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-29
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN675812084N0402X
OH35.0990642084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology