Provider Demographics
NPI:1144246075
Name:MOSKOWITZ, NATHAN CARL (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:CARL
Last Name:MOSKOWITZ
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 N ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-1829
Mailing Address - Country:US
Mailing Address - Phone:301-309-0566
Mailing Address - Fax:301-294-0721
Practice Address - Street 1:212 N ADAMS ST
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-1829
Practice Address - Country:US
Practice Address - Phone:301-309-0566
Practice Address - Fax:301-294-0721
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD32683174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD601611Medicare ID - Type Unspecified
MDE41503Medicare UPIN