MEDICARE: MOISE JOSEPH 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
1	2084P0800X	Psychiatry Physician	58793	GA
2	2084P0800X	Psychiatry Physician	33517	AZ

General Provider Information

NPI Number	:	1942420419
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOISE JOSEPH MD

Provider Business Mailing Address
First Line	:	PO BOX 530077
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30353-0077
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4225 W GLENDALE AVE
Second Line	:	E119
City	:	PHOENIX
State	:	AZ
Zip	:	85051-8194
Country	:	US
Telephone Number	:	623-915-0270
Fax Number	:	623-915-4837

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2007
Last Update Date	:	01/30/2024

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Directions to “ MOISE JOSEPH MD” Practice Location

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