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NPI Code Detail

MEDICARE: DR. DONNALYN MOELLER DPM

MEDICARE: DR. DONNALYN MOELLER DPM
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
1213E00000XPodiatrist3600995OH

Other Identifiers

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

General Provider Information

NPI Number : 1568456630
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DONNALYN MOELLER DPM
Provider Business Mailing Address
First Line : 3131 W BROAD ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43204-1306
Country : US
Telephone Number : 614-272-8854
Fax Number : 614-272-9200
Provider Business Practice Location Address
First Line : 3131 W BROAD ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43204-1306
Country : US
Telephone Number : 614-272-8854
Fax Number : 614-272-9200
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2005
Last Update Date : 05/28/2015

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Directions to “ DR. DONNALYN MOELLER DPM” Practice Location

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