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Individual

GERARD M MOSBY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
10201 E JEFFERSON AVE, SUITE 201A, DETROIT, MI 48214-3149
(313) 821-3777
(313) 824-3777
Mailing address
DEPT 999360 PO BOX 33738, DETROIT, MI 48232-3738
(810) 720-5715
(810) 732-0891

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301051836
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2673288
MI
05
4502397
MI
Enumeration date
11/03/2005
Last updated
11/10/2015
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