Individual
MOSES MIKE AVEDIKIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
18 E LAUREL RD, STRATFORD, NJ 08084
(856) 346-7985
Mailing address
18 E LAUREL RD, STRATFORD, NJ 08084-1327
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
25MB11355900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
99103253D
—
CA
Enumeration date
07/02/2019
Last updated
05/25/2022
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