Individual
MOSES AGBONAVBARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
201 E UNIVERSITY PKWY, BALTIMORE, MD 21218-2829
(410) 554-2002
Mailing address
9072 MEADOW HEIGHTS RD, RANDALLSTOWN, MD 21133-3646
(410) 413-0342
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
10/08/2021
Last updated
11/29/2021
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