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Individual
GARY MOELICH
Active
Individual
GARY MOELICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AA
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
002862
GA
367H00000X
Anesthesiologist Assistant
Primary
AAA0000021
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1014522
—
VT
Enumeration date
10/23/2006
Last updated
03/28/2008
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