Individual
ELIZABETH ANN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
7700 UNIVERSITY DR, WEST CHESTER, OH 45069-2505
(513) 475-8248
(513) 475-8468
Mailing address
2830 VICTORY PKWY, CINCINNATI, OH 45206-1785
(513) 245-3031
(513) 585-5511
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
34011081
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0091384
—
OH
01
—
34011081
OHIO LICENSE
OH
Enumeration date
10/01/2009
Last updated
01/14/2020
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