Individual
TAREK MOUSSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4437 STATE ROUTE 159 STE 125, CHILLICOTHE, OH 45601-7065
(740) 779-4570
(740) 779-4579
Mailing address
4437 STATE ROUTE 159, STE 125, CHILLICOTHE, OH 45601-7065
(740) 374-4500
(740) 374-5887
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
35095949
OH
207RI0011X
Interventional Cardiology Physician
Primary
35.095949
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000669833
ANTHEM
OH
01
—
000000696921
ANTHEM
OH
05
—
3101002
—
OH
05
—
3810018548
—
WV
01
—
P00931604
RRMCR
OH
Enumeration date
10/14/2009
Last updated
10/13/2020
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