Individual
DR. MOSES DESMOND DEGRAFT-JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2623 CENTENNIAL BLVD, SUITE 102, TALLAHASSEE, FL 32308-0585
(850) 792-4722
(850) 792-4727
Mailing address
400 CAPITAL CIR SE, STE 18148, TALLAHASSEE, FL 32301-3802
(850) 792-4722
(850) 792-4727
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
ME106359
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010916300
—
FL
Enumeration date
11/30/2008
Last updated
05/18/2017
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