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Individual

DEBORAH LYNNE MORITZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
161 CLINE AVENUE, MANSFIELD, OH 44907
(419) 756-5739
(419) 756-4968
Mailing address
2244 PARK CIR, LEWIS CENTER, OH 43035-6052
(740) 549-2596
(740) 549-0047

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
35054857M
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0856720
OH
01
3600681818
CLIA
OH
Enumeration date
09/15/2006
Last updated
05/14/2014
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