MEDICARE: HART MASON MOSELEY

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	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	B202407920	VA

General Provider Information

NPI Number	:	1962346502
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HART MASON MOSELEY

Provider Business Mailing Address
First Line	:	2265 TRANT LAKE DR
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-2132
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2265 TRANT LAKE DR
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-2132
Country	:	US
Telephone Number	:	252-256-0151
Fax Number	:

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

Provider Enumeration Date	:	04/15/2026
Last Update Date	:	04/15/2026

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Directions to “ HART MASON MOSELEY ” Practice Location

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