Provider Information for 1710906961
The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know
RONALD W MOESTA MSW
Sex: Male
NPI: 1710906961
Last Updated: 2022-01-18
Certification Date: 2022-01-18
Certification Date: 2022-01-18
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1710906961 | ||||||||
| Enumeration Date | 2006-07-19 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 17589 HIBMA RD TUSTIN, MI 49688-8168 United States Phone: | Fax: | ||||||||
| Primary Practice Address | 17589 HIBMA RD TUSTIN, MI 49688-8168 United States Phone: 231-745-3116 | Fax: | ||||||||
| Secondary Practice Address(es) | |||||||||
| Health Information Exchange |
| ||||||||
| Other Identifiers |
| ||||||||
| Taxonomy |
|