Individual
JOHN C MOGHTADER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2001 MEDICAL PKWY, ANNAPOLIS, MD 21401-3280
(443) 481-1366
Mailing address
2001 MEDICAL PKWY, ANNAPOLIS, MD 21401-3280
(443) 481-1366
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
D55979
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60055702
BLUE SHIELD
MD
01
—
T2390008
GHI
DC
Enumeration date
08/17/2006
Last updated
07/08/2007
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