Doctor Name: | DR. STEPHEN G MOELLER |
NPI Number: | 1013999069 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 27125 |
Business Practice Address: | 1 Medical Village Dr Edgewood, KY - 410173403 |
Business Phone Number: | 8593012160 |
Business Fax Number: | 8593013932 |
Mailing Address: | Po Box 932163, CLEVELAND |
State: | OH |
Postal Code: | 441930001 |
Phone Number: | 5864124000 |
Fax Number: | 5864124100 |
NPI Enumeration Date: | 11/16/2005 |
NPI Last Update Date: | 08/08/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085R0202X |
License Number: | 27125 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Diagnostic Radiology |
Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |