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General NPI Number Information
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NPI Number | 1467566125
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Entity Type | Individual
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Provider Name | BENJAMIN DEAN MOSHER M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/19/2006
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 1200 E MICHIGAN AVE STE 655
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City | LANSING
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State | MI
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Zip | 48912-1837
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Country | US
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Telephone | 517-267-2460
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Fax | 517-267-2462
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Provider Business Mailing Address
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Address Line | 804 SERVICE RD # A201
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City | EAST LANSING
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State | MI
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Zip | 48824-7015
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Country | US
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Telephone | 517-884-2976
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Fax | 517-432-3928
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 4301067886
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | 4301067886
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License Number State | MI
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