Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | D0063943 | MD |
NPI | 1629104583 |
---|---|
Provider Name | Dr. David Philip Moss |
First Address | New York City, NY 21231 |
Second Address | Chevy Chase, MD 20815-6901 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2007 |
Last Update Date | 14/12/2009 |