Individual
DR. MICHAEL GLENN MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
654 S MAIN ST, BAXLEY, GA 31513-0124
(912) 367-4122
(912) 367-4136
Mailing address
PO BOX 2070, BAXLEY, GA 31515-2070
(912) 367-9841
(912) 367-7203
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
66543
GA
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
66543
GA
Other
Enumeration date
07/08/2008
Last updated
06/30/2022
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