Provider Demographics
NPI:1770569576
Name:JOSEPH J MORAVEC, MD, INC
Entity type:Organization
Organization Name:JOSEPH J MORAVEC, MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORAVEC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-772-2442
Mailing Address - Street 1:1130 CONGRESS AVENUE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45246
Mailing Address - Country:US
Mailing Address - Phone:513-772-2442
Mailing Address - Fax:513-772-2844
Practice Address - Street 1:1130 CONGRESS AVENUE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45246
Practice Address - Country:US
Practice Address - Phone:513-772-2442
Practice Address - Fax:513-772-2844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-22
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0384301Medicaid
OH0458762Medicare PIN
OH4225221Medicare PIN