Individual
JEFFERY J MOLEDOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1930 CROWN PARK CT, COLUMBUS, OH 43235-2402
(614) 457-1793
(614) 457-4051
Mailing address
1930 CROWN PARK CT, COLUMBUS, OH 43235-2402
(614) 457-1793
(614) 457-4051
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35-04-6701
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0719128
—
OH
Enumeration date
11/28/2005
Last updated
03/15/2011
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