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Individual

BRIAN W MOSS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1717 ARLINGTON AVE, CALDWELL, ID 83605-4802
(208) 459-4641
Mailing address
2965 S BERGMAN WAY, EAGLE, ID 83616-4986
(208) 949-8857

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
M-10302
ID
207P00000X
Emergency Medicine Physician
Primary
P3936
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
808048600
ID
Enumeration date
04/28/2008
Last updated
02/12/2026
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