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NPI Code Detail

MEDICARE: MR. BURTON ALAN MOSS MD

MEDICARE: MR. BURTON ALAN MOSS MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207K00000XAllergy & Immunology Physician0101015046VA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2C01592OTHERVAMEDICARE GROUP #
4CN5602OTHERVARAILROAD MEDICARE GROUP #

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11285634253OTHERVAINDIVIDUAL NPI#
31326022880OTHERVAGROUP NPI#

General Provider Information

NPI Number : 1285634253
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BURTON ALAN MOSS MD
Provider Business Mailing Address
First Line : 302A E LITTLE CREEK RD
Second Line :
City : NORFOLK
State : VA
Zip : 23505-2603
Country : US
Telephone Number : 757-583-4382
Fax Number : 757-480-3675
Provider Business Practice Location Address
First Line : 302A E LITTLE CREEK RD
Second Line :
City : NORFOLK
State : VA
Zip : 23505-2603
Country : US
Telephone Number : 757-583-4382
Fax Number : 757-480-3675
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2005
Last Update Date : 01/14/2008

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Directions to “ MR. BURTON ALAN MOSS MD” Practice Location

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