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Individual

JOHN K MOFFA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4030 WEST HENDERSON ROAD, COLUMBUS, OH 43220
(614) 442-7550
(614) 442-4100
Mailing address
4030 WEST HENDERSON ROAD, COLUMBUS, OH 43220
(614) 442-7550
(614) 442-4100

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35-07-1014
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2046075
OH
Enumeration date
12/29/2005
Last updated
10/02/2012
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