Individual
DR. CHARLES HARDY MOSHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8303 DODGE ST, OMAHA, NE 68114-4108
(402) 354-4540
(402) 354-4535
Mailing address
PO BOX 2797, OMAHA, NE 68103-2797
(402) 354-4230
(402) 354-6171
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
33649
IA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
33649
IA
208600000X
Surgery Physician
33649
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1164492997
WELLMARK
NE
05
—
1164492997
—
IA
05
—
470376604-22
—
NE
Enumeration date
01/24/2006
Last updated
12/17/2013
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