Individual
CARLY MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3001 HOSPITAL DR, CHEVERLY, MD 20785-1189
(301) 618-3779
Mailing address
3728 GUNSTON RD BLDG 918, ALEXANDRIA, VA 22302-2008
(843) 319-2650
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0007646
MD
Other
Enumeration date
07/22/2016
Last updated
09/06/2020
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