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Individual

AMANDA K MOSMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
426 8TH ST STE 101, GLEN DALE, WV 26038-1451
(304) 221-4588
Mailing address
426 8TH ST STE 101, GLEN DALE, WV 26038-1451
(304) 221-4588

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1327
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
APPLIED FOR
MEDCOST
NC
Enumeration date
10/24/2006
Last updated
07/10/2023
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