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
Phone: (302) 733-5982
Fax:
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1912907197 | NPPES |
| Pennsylvania | MEDICAID | 0018727880005 | |
| Pennsylvania | MEDICAID | 2095572 |
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