Provider Demographics
NPI:1811170020
Name:S NEMAT MOUSSAVIAN MD INC
Entity type:Organization
Organization Name:S NEMAT MOUSSAVIAN MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SEYED
Authorized Official - Middle Name:NEMATOLAH
Authorized Official - Last Name:MOUSSAVIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-891-1240
Mailing Address - Street 1:9200 MONTGOMERY RD
Mailing Address - Street 2:BLDG. E SUITE 18A
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-7789
Mailing Address - Country:US
Mailing Address - Phone:513-891-1240
Mailing Address - Fax:513-891-3561
Practice Address - Street 1:9200 MONTGOMERY RD
Practice Address - Street 2:BLDG. E SUITE 18A
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-7789
Practice Address - Country:US
Practice Address - Phone:513-891-1240
Practice Address - Fax:513-891-3561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-11
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9263771Medicare PIN
OHW41719Medicare UPIN