Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 154972 | MA |
NPI | 1003874959 |
---|---|
Provider Name | Hamilton Moses III |
First Address | North Garden, VA 22959-0150 |
Second Address | Baltimore, MD 21287-0000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2006 |
Last Update Date | 23/01/2017 |