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Individual

MOTAZ MOUSSA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
410 LIONEL WAY STE 201, DAVENPORT, FL 33837-7809
(863) 422-5331
(863) 422-5336
Mailing address
PO BOX 449, MARIETTA, OH 45750-0449
(740) 374-4500
(740) 374-5887

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
35.129093
OH
207RI0011X
Interventional Cardiology Physician
35.129093
OH
207RI0011X
Interventional Cardiology Physician
Primary
ME156847
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0175394
OH
01
P01784682
RAILROAD MEDICARE - MHCPI
OH
Enumeration date
02/03/2010
Last updated
10/23/2023
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