Individual
LEO MOYSAENKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
33001 SOLON RD, SOLON, OH 44139-2839
(440) 349-2516
Mailing address
4410 W RIDGEWOOD DR, PARMA, OH 44134-4122
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35052898
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0708032
—
OH
01
—
942460636142
CARESOURCE
OH
01
—
P00222425
MEDICARE RR-GA
OH
Enumeration date
06/09/2006
Last updated
07/08/2007
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