Provider Demographics
NPI:1508822354
Name:MOSIER, MICHAEL L (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:L
Last Name:MOSIER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2900 AMHERST AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66503-3003
Mailing Address - Country:US
Mailing Address - Phone:785-539-8700
Mailing Address - Fax:785-776-9788
Practice Address - Street 1:2900 AMHERST AVE
Practice Address - Street 2:SUITE A
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66503-3003
Practice Address - Country:US
Practice Address - Phone:785-539-8700
Practice Address - Fax:785-776-9788
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2010-07-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS0418435207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSDO5285Medicare UPIN
KS055682MOMedicare ID - Type Unspecified