MEDICARE: MOSES FAMILY MEDICINE, INC.

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	207Q00000X	Family Medicine Physician	19364	WV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	001858663	OTHER	WV	BC/BS

General Provider Information

NPI Number	:	1043329881
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOSES FAMILY MEDICINE, INC.

Provider Business Mailing Address
First Line	:	2959 3RD AVE
Second Line	:
City	:	HUNTINGTON
State	:	WV
Zip	:	25702-1401
Country	:	US
Telephone Number	:	304-781-3589
Fax Number	:

Provider Business Practice Location Address
First Line	:	2959 3RD AVE
Second Line	:
City	:	HUNTINGTON
State	:	WV
Zip	:	25702-1401
Country	:	US
Telephone Number	:	304-781-3589
Fax Number	:

Authorized Official
Title or Position	:	OWNER/MD
Name	:	MELIN MOSES
Credential	:	MD
Telephone Number	:	304-781-3589

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	03/04/2026

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