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NPI Code Detail

MEDICARE: DR. ROBERT A MOSS PH.D.

MEDICARE: DR. ROBERT A MOSS PH.D.
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
1103G00000XClinical NeuropsychologistPSY1000980DC
2103T00000XPsychologist384SC
3103TC0700XClinical PsychologistPSY1000980DC
4103G00000XClinical Neuropsychologist384SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1699861278
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT A MOSS PH.D.
Provider Business Mailing Address
First Line : 300 E MCBEE AVE FL 4
Second Line :
City : GREENVILLE
State : SC
Zip : 29601-2842
Country : US
Telephone Number : 864-522-8603
Fax Number : 202-452-1853
Provider Business Practice Location Address
First Line : 10 PATEWOOD DR STE 130
Second Line :
City : GREENVILLE
State : SC
Zip : 29615-6317
Country : US
Telephone Number : 864-455-8988
Fax Number : 864-455-4540
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2006
Last Update Date : 01/05/2023

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Directions to “ DR. ROBERT A MOSS PH.D.” Practice Location

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