Individual
MUSTAFA MOSHREF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7333 W JEFFERSON BLVD, FORT WAYNE, IN 46804-6280
(260) 458-3830
Mailing address
1234 E DUPONT RD, SUITE 1, FORT WAYNE, IN 46825-1545
(260) 373-7854
(260) 458-5664
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71005352A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201308850
—
IN
Enumeration date
06/30/2015
Last updated
01/05/2026
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