MEDICARE: DR. RICHARD S MORAITES MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	35021342M	OH
2	207ND0101X	MOHS-Micrographic Surgery Physician	35021342M	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154482107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD S MORAITES MD

Provider Business Mailing Address
First Line	:	7717 MONTGOMERY ROAD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45236-4201
Country	:	US
Telephone Number	:	513-793-4021
Fax Number	:	513-793-4078

Provider Business Practice Location Address
First Line	:	7717 MONTGOMERY ROAD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45236-4201
Country	:	US
Telephone Number	:	513-793-4021
Fax Number	:	513-793-4078

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/13/2006
Last Update Date	:	07/21/2010

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