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NPI Code Detail

MEDICARE: SCOTT MOSES MD

MEDICARE: SCOTT MOSES MD
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
1207Q00000XFamily Medicine Physician38030MN

General Provider Information

NPI Number : 1508817149
Entity Type Code : Individual
Provider Name (Legal Business Name) : SCOTT MOSES MD
Provider Business Mailing Address
First Line : 5200 FAIRVIEW BLVD
Second Line :
City : WYOMING
State : MN
Zip : 55092-8013
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7455 VILLAGE DR
Second Line :
City : LINO LAKES
State : MN
Zip : 55014-1181
Country : US
Telephone Number : 651-717-3400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2006
Last Update Date : 06/16/2008

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Directions to “ SCOTT MOSES MD” Practice Location

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