MEDICARE: MICHELLE MOH M.D.

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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	A134820	CA
2	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	71869	WI
3	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	35.146403	OH

General Provider Information

NPI Number	:	1790027092
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE MOH M.D.

Provider Business Mailing Address
First Line	:	9500 EUCLID AVE # L15
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44195-0001
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9500 EUCLID AVE # L15
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44195-3522
Country	:	US
Telephone Number	:	800-628-6816
Fax Number	:

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

Provider Enumeration Date	:	03/25/2013
Last Update Date	:	09/20/2022

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Directions to “ MICHELLE MOH M.D.” Practice Location

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