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Individual
MICHAEL LOWELL MOULTON
Active
Individual
MICHAEL LOWELL MOULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
E-4391
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
156776001
—
AR
05
—
200054700A
—
OK
01
—
5N139
AR BC/BS
AR
01
—
P00219962
RR MCR
AR
Enumeration date
06/23/2006
Last updated
11/06/2013
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