Individual
CHARLES MOSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 ST. JOHNS BLVD, SUITE 101, MAPLEWOOD, MN 55109-1190
(651) 842-5355
(651) 770-9153
Mailing address
PO BOX 86 SDS 12 2901, MINNEAPOLIS, MN 55486-2901
(651) 968-5050
(651) 968-5900
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
25704
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200031318
RAILROAD MEDICARE
MN
05
—
549598900
—
MN
Enumeration date
03/14/2006
Last updated
12/04/2009
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