Individual
MARK W MORONELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1380 E STROOP RD, KETTERING, OH 45429
(937) 293-3486
(937) 293-3605
Mailing address
1380 E STROOP RD, KETTERING, OH 45429-4926
(937) 293-3486
(937) 293-3605
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
35.122658
OH
207RC0000X
Cardiovascular Disease Physician
4457
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0097860
—
OH
01
—
060058886
RAILROAD MEDICARE
AK
05
—
MD1321
—
AK
Enumeration date
07/17/2006
Last updated
01/12/2021
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