Individual
DR. EMMANUEL OLUMUYIWA MOSES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT, OCS, CCI
Contact information
Practice address
12150 ANNAPOLIS RD, SUITE 201, GLENN DALE, MD 20769
(301) 352-8370
(301) 352-8372
Mailing address
12150 ANNAPOLIS RD, SUITE 201, GLENN DALE, MD 20769-9183
(301) 352-8370
(301) 352-8372
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
21846
MD
2251X0800X
Orthopedic Physical Therapist
21846
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
045308100
—
MD
01
—
616235300
WORKERS COMPENSATION NUMBER
—
Enumeration date
11/01/2006
Last updated
07/15/2018
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