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General NPI Number Information
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NPI Number | 1285772582
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Entity Type | Individual
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Provider Name | SEYED NEMATOLAH MOUSSAVIAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 10/31/2017
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Provider Practice Location Address
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Address Line | 9200 MONTGOMERY RD
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City | CINCINNATI
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State | OH
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Zip | 45242-7789
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Country | US
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Telephone | 513-891-1240
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Fax | 513-891-3561
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Provider Business Mailing Address
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Address Line | 9200 MONTGOMERY RD
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City | CINCINNATI
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State | OH
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Zip | 45242-7789
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Country | US
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Telephone | 513-891-1240
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Fax | 513-891-3561
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 20120
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 35-041367
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 01079427B
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License Number State | IN
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