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General NPI Number Information
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NPI Number | 1669094512
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Entity Type | Individual
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Provider Name | AUSTIN WILLIAM MOATS CAA
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Gender | Male
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Dates
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Enumeration Date | 05/14/2020
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Last Update Date | 03/25/2024
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Provider Practice Location Address
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Address Line | 5255 LOUGHBORO RD NW
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City | WASHINGTON
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State | DC
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Zip | 20016-2633
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Country | US
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Telephone | 202-537-4686
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Fax | 202-537-4965
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Provider Business Mailing Address
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Address Line | 5255 LOUGHBORO RD NW
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City | WASHINGTON
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State | DC
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Zip | 20016-2633
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Country | US
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Telephone | 202-537-4686
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Fax | 202-537-4965
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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 | 367H00000X
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Taxonomy Name | Anesthesiologist Assistant
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License Number | AA2000051
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License Number State | MD
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