Provider Demographics
NPI:1407995806
Name:MOSKAL, MICHAEL J (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:MOSKAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:130 HUNTERS STATION WAY
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SELLERSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47172
Mailing Address - Country:US
Mailing Address - Phone:812-248-4789
Mailing Address - Fax:812-248-4773
Practice Address - Street 1:130 HUNTERS STATION WAY
Practice Address - Street 2:SUITE 201
Practice Address - City:SELLERSBURG
Practice Address - State:IN
Practice Address - Zip Code:47172
Practice Address - Country:US
Practice Address - Phone:812-248-4789
Practice Address - Fax:812-248-4773
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2011-08-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01049141207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN178390Medicare ID - Type UnspecifiedMEDICARE ID NUMBER