Individual
KEVIN MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
W180N7950 TOWN HALL RD, MENOMONEE FALLS, WI 53051-4049
(262) 255-2500
Mailing address
W180N7950 TOWN HALL RD, MENOMONEE FALLS, WI 53051-4049
(262) 255-2500
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
32039
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31703300
—
WI
Enumeration date
02/13/2006
Last updated
01/27/2014
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