Individual
PERRY D MOSTOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1344 WINTERGREEN LN NE, BAINBRIDGE ISLAND, WA 98110
(206) 842-5632
(206) 842-5992
Mailing address
1344 WINTERGREEN LN NE, BAINBRIDGE ISLAND, WA 98110-5118
(206) 842-5632
(206) 842-5992
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
34004921
OH
207Q00000X
Family Medicine Physician
Primary
OP60744283
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0950734
—
OH
Enumeration date
04/08/2006
Last updated
06/18/2018
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