Degraft-Johnson, Moses Desmond

Degraft-Johnson, Moses Desmond is an sole proprietor health care provider with primary practice located at 2623 Centennial Blvd Suite 102, Tallahassee FL 32308-0585. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as his primary health care specialty. Degraft-Johnson, Moses Desmond can be contacted via phone (850) 792-4722.

Contact Information

Primary practice address
2623 Centennial Blvd Suite 102 Tallahassee FL 32308-0585
Phone: (850) 792-4722
Fax: (850) 792-4727
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X ME106359 Florida

Profile Details

NPI number 1194970475
LBN Legal business name Degraft-Johnson, Moses Desmond
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 30th, 2008
Last updated May 18th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194970475 NPPES
Florida MEDICAID 010916300

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