Individual
RENATA MILENA STOSZEK MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
322 W NORTH RIVER DR, SPOKANE, WA 99201-3208
(509) 324-6464
Mailing address
6451 N FEDERAL HWY, FORT LAUDERDALE, FL 33308-1402
(877) 336-6077
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD00043974
WA
208000000X
Pediatrics Physician
Primary
ME154557
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8402687
—
WA
01
—
AB32999
MEDICARE GROUP
WA
Enumeration date
05/24/2006
Last updated
12/08/2022
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