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General NPI Number Information
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NPI Number | 1265405260
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Entity Type | Individual
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Provider Name | MOISES RIMMER COSSIO D.O.
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Gender | Male
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Dates
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Enumeration Date | 02/09/2006
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Last Update Date | 12/10/2020
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Provider Practice Location Address
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Address Line | 2001 CRYSTAL SPRING AVE SW SUITE 205
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City | ROANOKE
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State | VA
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Zip | 24014-2462
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Country | US
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Telephone | 540-985-8505
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Fax | 540-344-3313
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Provider Business Mailing Address
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Address Line | PO BOX 936
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City | NORFOLK
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State | VA
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Zip | 23501-0936
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Country | US
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Telephone | 757-446-5758
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Fax | 757-446-5242
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0102201314
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 0102201314
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 0102201314
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License Number State | VA
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