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NPI Code Detail

MEDICARE: DR. JEFFREY D MOSER D.P.M.

MEDICARE: DR. JEFFREY D MOSER D.P.M.
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
1213E00000XPodiatrist2002MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1Y70973OTHERMABLUE CROSS BLUE SHIELD
233456OTHERMAHARVARD PILGRIM
3002002OTHERMATUFTS

General Provider Information

NPI Number : 1730225582
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JEFFREY D MOSER D.P.M.
Provider Business Mailing Address
First Line : 57 CITY HALL AVE
Second Line :
City : GARDNER
State : MA
Zip : 01440-2614
Country : US
Telephone Number : 978-630-3862
Fax Number :
Provider Business Practice Location Address
First Line : 57 CITY HALL AVE
Second Line :
City : GARDNER
State : MA
Zip : 01440-2614
Country : US
Telephone Number : 978-630-3862
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2007
Last Update Date : 12/04/2018

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