Healthcare Provider Details

I. General information

NPI: 1144911504
Provider Name (Legal Business Name): ELI JENNINGS MOSS DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2023
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY HOSPITALS CLEVELAND MEDICAL CENTER 11100 EUCLID AVENUE
CLEVELAND OH
44106
US

IV. Provider business mailing address

UNIVERSITY HOSPITALS CLEVELAND MEDICAL CENTER 11100 EUCLID AVENUE
CLEVELAND OH
44106
US

V. Phone/Fax

Practice location:
  • Phone: 216-844-8447
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number34.018852
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: