Moussouttas, Michael M

Moussouttas, Michael M is an individual health care provider with primary practice located at 4755 Ogletown Stanton Rd Ste 2E99 , Newark DE 19718-2559. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Vascular Neurology, Allopathic & Osteopathic Physicians / Neurology, Allopathic & Osteopathic Physicians / Neurocritical Care. Allopathic & Osteopathic Physicians / Neurology is his primary health care specialty. Moussouttas, Michael M can be contacted via phone (302) 733-5982.

Contact Information

Primary practice address
4755 Ogletown Stanton Rd Ste 2E99 Newark DE 19718-2559
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular Neurology 2084V0102X MD432784 Pennsylvania
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 201294 New York
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 25MA07658800 New Jersey
Allopathic & Osteopathic Physicians / Neurocritical Care 2084A2900X NCC00372-08 New Jersey
Allopathic & Osteopathic Physicians / Neurocritical Care 2084A2900X NCC00372-08 Pennsylvania
Allopathic & Osteopathic Physicians / Vascular Neurology 2084V0102X 25MA07658800 New Jersey
Allopathic & Osteopathic Physicians / Neurology 2084N0400X MD432784 Pennsylvania
Allopathic & Osteopathic Physicians / Neurology 2084N0400X C1-0012292 Delaware

Profile Details

NPI number 1912907197
LBN Legal business name Moussouttas, Michael M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 28th, 2005
Last updated Jul 21st, 2022 - about 2 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 1912907197 NPPES
Pennsylvania MEDICAID 0018727880005
Pennsylvania MEDICAID 2095572

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