Healthcare Provider Details

I. General information

NPI: 1306935846
Provider Name (Legal Business Name): WILLIAM E MOATS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 05/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 N MAIN ST
AKRON OH
44310-3110
US

IV. Provider business mailing address

444 N MAIN ST
AKRON OH
44310-3110
US

V. Phone/Fax

Practice location:
  • Phone: 330-375-6363
  • Fax:
Mailing address:
  • Phone: 330-375-6363
  • Fax: 330-379-5144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number35025905
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: