Organization
HOLY FAMILY PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL ANTHONY MOELL M.D. (OWNER)
(937) 586-9665
Entity
Organization
Contact information
Practice address
359 FOREST AVE, SUITE 106, DAYTON, OH 45405-4563
(937) 586-9665
Mailing address
359 FOREST AVE, SUITE 106, DAYTON, OH 45405-4563
(937) 586-9665
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
35062607-M
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2748736
—
OH
Enumeration date
04/11/2007
Last updated
03/27/2008
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