Individual
RICHARD E MOULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1400 MERCY DR, SUITE 100, MUSKEGON, MI 49444-1836
(231) 733-1326
(231) 830-2764
Mailing address
1400 MERCY DR, SUITE 100, MUSKEGON, MI 49444-1836
(231) 733-1326
(231) 830-2764
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
4301027415
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1789986
—
MI
01
—
4301027415
STATE LICENSE
MI
Enumeration date
04/10/2006
Last updated
10/24/2012
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