Individual
ANDREW K MOSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
593 EDDY ST, CLAVERICK 2ND FLOOR, PROVIDENCE, RI 02903-4923
(401) 444-5175
(401) 444-8874
Mailing address
PO BOX 9484, PROVIDENCE, RI 02940-9484
(401) 854-2504
(401) 854-2519
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00352
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-01-2008
BCBS
RI
01
—
01-15-2008
NHPRI
RI
01
—
1750309951
NPI
—
05
—
9003981
—
RI
01
—
939025129
RI MEDICARE GROUP NUMBER
—
Enumeration date
07/17/2006
Last updated
02/18/2014
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