Individual
MOUSSON BERROUET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1110 ANNAPOLIS RD, ODENTON, MD 21113-1602
(443) 351-3917
Mailing address
5000 COX RD, GLEN ALLEN, VA 23060-9263
(804) 822-4355
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
H0095795
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/15/2019
Last updated
04/22/2024
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