Moss, Mark Jeffrey

Moss, Mark Jeffrey is an individual health care provider with primary practice located at 29701 6 Mile Rd #100A, Livonia MI 48152-8600. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Moss, Mark Jeffrey can be contacted via phone (734) 261-3808.

Contact Information

Primary practice address
29701 6 Mile Rd #100A Livonia MI 48152-8600
Phone: (734) 261-3808
Fax: (734) 261-3821
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 5901000715 Michigan

Profile Details

NPI number 1508870361
LBN Legal business name Moss, Mark Jeffrey
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 28th, 2006
Last updated Nov 21st, 2013 - about 11 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 1508870361 NPPES
Michigan MEDICAID 1352311
Michigan Other 480045246
Michigan Other 382334116
Michigan Other 4858254620

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