Basic Information
| Provider Information | |||||||||
| NPI: | 1558480582 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AURON | ||||||||
| FirstName: | MOISES | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6000 W CREEK RD | ||||||||
| Address2: | SUITE 10 | ||||||||
| City: | INDEPENDENCE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441312139 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8002232273 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9500 EUCLID AVE | ||||||||
| Address2: | M2 ANNEX | ||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441950001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2164458383 | ||||||||
| FaxNumber: | 2164448530 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/29/2007 | ||||||||
| LastUpdateDate: | 05/02/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 35086922 | OH | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 35086922 | OH | Y | Allopathic & Osteopathic Physicians | Hospitalist | 208000000X | 35086922 | OH | N | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 2730110 | 05 | OH | MEDICAID |