Individual
JEREMY MOSES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1824 PISGAH DR, HENDERSONVILLE, NC 28791-3759
(828) 694-8427
(828) 694-8428
Mailing address
800 N JUSTICE ST # 16, HENDERSONVILLE, NC 28791-3410
(828) 694-8350
(828) 694-7654
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-05865
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19ELC
BCBS NC
NC
01
—
NCP403A
MEDICARE PTAN
NC
01
—
P01548044
RR MEDICARE
NC
Enumeration date
08/05/2015
Last updated
09/13/2019
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