Individual
DR. RICHARD LEE MOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-1100
(801) 587-6340
(801) 587-6346
Mailing address
PO BOX 3208, SALT LAKE CITY, UT 84110-3208
(801) 587-6340
(801) 587-6346
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
161345-1205
UT
207ND0900X
Dermatopathology Physician
161345-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070013782
RR MEDICARE
—
Enumeration date
11/10/2006
Last updated
11/08/2021
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