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Individual

DR. MICHAEL ARTHUR MOSS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
724 DELAWARE AVE, FOUNTAIN HILL, PA 18015-1108
(800) 257-8715
(800) 819-1655
Mailing address
5 OBERLIN AVE, SWARTHMORE, PA 19081-1626
(610) 544-8679

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS007161L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0015352780008
PA
01
6100543
EVERCARE
01
680013328
RAIL ROAD
01
749181
BLUE CROSS BLUE SHIELD
PA
Enumeration date
05/31/2006
Last updated
09/15/2008
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