Moose, Beverly Dawn

Moose, Beverly Dawn is an individual health care provider with primary practice located at 3333 Silas Creek Pkwy , Winston Salem NC 27103-3013. She recently has only one registered license in Allopathic & Osteopathic Physicians / Radiation Oncology, which is considered as her primary health care specialty. Moose, Beverly Dawn can be contacted via phone (336) 718-5095.

Contact Information

Primary practice address
3333 Silas Creek Pkwy Winston Salem NC 27103-3013
Phone: (336) 718-5095
Fax: (336) 718-9895
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Radiation Oncology 2085R0001X 96-00124 North Carolina

Profile Details

NPI number 1487747648
LBN Legal business name Moose, Beverly Dawn
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 2nd, 2006
Last updated Dec 11th, 2012 - about 13 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 1487747648 NPPES
Other 97953 MEDCOST
Other 6760232005 MEDCOST
MEDICAID 8960531 MEDCOST
Other 13799 MEDCOST
Other 60531 MEDCOST
Other 2408394 MEDCOST
MEDICAID 5860531 MEDCOST

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