Individual
DR. MOISES RIMMER COSSIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2001 CRYSTAL SPRING AVE SW, SUITE 205, ROANOKE, VA 24014-2462
(540) 985-8505
(540) 344-3313
Mailing address
PO BOX 936, NORFOLK, VA 23501-0936
(757) 446-5758
(757) 446-5242
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0102201314
VA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
0102201314
VA
207RP1001X
Pulmonary Disease Physician
Primary
0102201314
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
-029
TRICARE/CHAMPUS
VA
01
—
00864
MEDICAID BC BS
NC
05
—
010160511
—
VA
01
—
177113
ANTHEM
VA
01
—
3159697
UHC/MAMSI
VA
05
—
5900864
—
NC
01
—
96131
SENTARA OPTIMA
VA
01
—
PAR
USA MANAGED CARE
VA
01
—
VV1744A
MEDICARE
VA
Enumeration date
02/09/2006
Last updated
12/10/2020
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