Individual
JEFFREY TAYLOR MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
269 GILLMAN RD STE 100, DENVER, NC 28037-7923
(704) 316-4930
(704) 316-4931
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2024-01551
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/18/2021
Last updated
08/08/2024
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