Individual
DR. BRAD L MOSELEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
795 TRAMWAY LN NE, ALBUQUERQUE, NM 87122-1606
(505) 314-3696
Mailing address
795 TRAMWAY LN NE, ALBUQUERQUE, NM 87122-1606
(505) 314-3696
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2000167451
MO
207Q00000X
Family Medicine Physician
Primary
91-272
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
205125107
—
MO
01
—
80167881
RAILROAD MEDICARE
MO
Enumeration date
07/21/2005
Last updated
05/20/2022
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