Moss, David Russell
Moss, David Russell is an individual health care provider with primary practice located at 800 Washington St Box 298, Boston MA 02111-1552. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Pediatric Anesthesiology. Allopathic & Osteopathic Physicians / Pediatric Anesthesiology is his primary health care specialty. Moss, David Russell can be contacted via phone (617) 636-6044.Contact Information
Primary practice address
800 Washington St Box 298
Boston MA 02111-1552
Phone: (617) 636-6044
Fax: (617) 636-8384
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 239306 | Massachusetts |
| Allopathic & Osteopathic Physicians / Pediatric Anesthesiology | 207LP3000X | 239306 | Massachusetts |
Profile Details
| NPI number | 1801922547 |
|---|---|
| LBN Legal business name | Moss, David Russell |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 26th, 2007 |
| Last updated | Nov 7th, 2010 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1801922547 | NPPES |
| Massachusetts | MEDICAID | 110083132/A |
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