Provider Demographics
NPI:1336457993
Name:MOJE, STEPHAN (DC DIBCN)
Entity Type:Individual
Prefix:DR
First Name:STEPHAN
Middle Name:
Last Name:MOJE
Suffix:
Gender:M
Credentials:DC DIBCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6635 MURRAY AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45227-4726
Mailing Address - Country:US
Mailing Address - Phone:218-205-6141
Mailing Address - Fax:
Practice Address - Street 1:8624 WINTON RD STE B
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-4837
Practice Address - Country:US
Practice Address - Phone:513-931-4300
Practice Address - Fax:513-898-9149
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-16
Last Update Date:2017-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4650-012111N00000X
MN5424111N00000X
MI2301 009712111N00000X
OH4113111NN0400X
PADC010283111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN0400XChiropractic ProvidersChiropractorNeurology