Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | 01055728A | IN |
NPI | 1790075638 |
---|---|
Provider Name | Dr. P. David Mozley |
First Address | Collegeville, PA 19426-1570 |
Second Address | Collegeville, PA 19426-1570 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2011 |
Last Update Date | 12/04/2011 |