Provider Demographics
NPI:1770044646
Name:MOISA, CLAUDIU ROMOLUS (MD)
Entity type:Individual
Prefix:
First Name:CLAUDIU
Middle Name:ROMOLUS
Last Name:MOISA
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 1:4402 CHURCHMAN AVE STE 410
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40215-3102
Mailing Address - Country:US
Mailing Address - Phone:502-588-8720
Mailing Address - Fax:
Practice Address - Street 1:4402 CHURCHMAN AVE STE 410
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40215-3102
Practice Address - Country:US
Practice Address - Phone:502-588-8720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-25
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY57535207Q00000X, 207QG0300X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program