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Individual
JOSH CHARLES MOULIN
Active
Individual
JOSH CHARLES MOULIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
282NR1301X
Rural Acute Care Hospital
T01460
KS
363A00000X
Physician Assistant
Primary
15-01214
KS
363A00000X
Physician Assistant
1501214
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30004521840001
—
KS
01
—
427174
MEDICARE ID UNSPECIFIED
KS
Enumeration date
08/10/2007
Last updated
07/30/2024
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