Organization
THOMAS AE MOSELEY
Active
Other names
Newport Pediatrics & Adolescent Medicine PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS AE MOSELEY III MD (OWNER)
(802) 334-5929
Entity
Organization
Contact information
Practice address
121 MEDICAL VILLAGE DRIVE, NEWPORT, VT 05855
(802) 334-6929
(802) 784-1051
Mailing address
121 MEDICAL VILLAGE DRIVE, NEWPORT, VT 05855
(802) 334-6929
(802) 784-1051
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
1010022369
VT
208000000X
Pediatrics Physician
0420010849
VT
208000000X
Pediatrics Physician
Primary
420006774
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0473814
—
VT
Enumeration date
11/16/2006
Last updated
03/14/2012
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