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Individual

DR. BRYAN EDWARD MOSORA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
1755 N MECKLENBURG AVE, SOUTH HILL, VA 23970-4080
(434) 584-5025
Mailing address
1345 RXR PLZ FL 13, UNIONDALE, NY 11556-1301
(516) 453-0435

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0102206048
VA
207Q00000X
Family Medicine Physician
LT22008
ME
207Q00000X
Family Medicine Physician
Primary
OP60864272
WA

Other

Enumeration date
12/12/2008
Last updated
08/12/2022
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