Individual
MR. DAVID MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3401 LUDINGTON ST, ESCANABA, MI 49829-1300
(906) 786-5707
Mailing address
825 N CENTER AVE, GAYLORD, MI 49735-1592
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704134919
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
4704134919
MI
Other
Enumeration date
02/18/2016
Last updated
09/17/2019
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