MOSCOW MEDICAL P.A. NPI 1871646976

NPI Information

MOSCOW MEDICAL, P.A. is a family medicine in Moscow, ID. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. MOSCOW MEDICAL, P.A. NPI is 1871646976. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

213 N MAIN ST
MOSCOW, ID
ZIP 83843-700
Phone: (208) 882-7565

The provider's authorized official is Kathy Cornish .
The authorized official title is Billing Manager and has the following contact phone number (208) 746-3653.

The CLIA number assigned to this NPI record is 13D0522285 - rural health clinic with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 1/19/2007 and was last updated on 3/31/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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