Individual
ETHAN ARON MOLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMPNA, CRNA
Contact information
Practice address
4605 MACCORKLE AVE SW, SOUTH CHARLESTON, WV 25309-1311
(304) 766-3600
Mailing address
1892 PATTERSON DR, ELKVIEW, WV 25071-7131
(304) 941-3630
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
85894
WV
367500000X
Certified Registered Nurse Anesthetist
Primary
112703
WV
Other
Enumeration date
05/19/2022
Last updated
05/19/2022
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