Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 0101270019 | VA |
NPI | 1811335011 |
---|---|
Provider Name | Dr. Peter Thomas Moskal |
First Address | Norfolk, VA 23502 |
Second Address | Norfolk, VA 23502 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2013 |
Last Update Date | 30/11/2020 |