Individual
DR. MARK ROBERT MOSES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
23214
OK
207X00000X
Orthopaedic Surgery Physician
Primary
23214
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0195480001
PALMETTO
OK
05
—
200065700A
—
OK
01
—
7689494
AETNA
OK
01
—
P00049091
RR MEDICARE
OK
Enumeration date
07/13/2005
Last updated
04/11/2023
Update your record
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