Provider Demographics
NPI:1558689471
Name:MORAVEC, WILLIAM JAMES (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:JAMES
Last Name:MORAVEC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 636256
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-6256
Mailing Address - Country:US
Mailing Address - Phone:513-245-3600
Mailing Address - Fax:
Practice Address - Street 1:3130 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2399
Practice Address - Country:US
Practice Address - Phone:513-584-3999
Practice Address - Fax:513-584-4111
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-17
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35 126534207V00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0OtherTHE UNIVERSITY HOSPITAL