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NPI Code Detail

MEDICARE: CHASE MOFFAT DPM

MEDICARE: CHASE MOFFAT DPM
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
1213E00000XPodiatristSC006756PA
2213ES0103XFoot & Ankle Surgery PodiatristPOD-001022AZ

General Provider Information

NPI Number : 1841643764
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHASE MOFFAT DPM
Provider Business Mailing Address
First Line : PO BOX 9058
Second Line :
City : MESA
State : AZ
Zip : 85214-9058
Country : US
Telephone Number :
Fax Number : 480-564-4904
Provider Business Practice Location Address
First Line : 2919 S ELLSWORTH RD STE 124
Second Line :
City : MESA
State : AZ
Zip : 85212-2167
Country : US
Telephone Number : 480-633-7944
Fax Number : 480-633-0255
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2016
Last Update Date : 03/17/2022

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Directions to “ CHASE MOFFAT DPM” Practice Location

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