Provider Demographics
NPI:1891743068
Name:MOSS, DAVID A (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:MOSS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1524 ATWOOD AVE
Mailing Address - Street 2:SUITE 140
Mailing Address - City:JOHNSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02919-3228
Mailing Address - Country:US
Mailing Address - Phone:401-351-6200
Mailing Address - Fax:401-351-6201
Practice Address - Street 1:1524 ATWOOD AVE
Practice Address - Street 2:SUITE 140
Practice Address - City:JOHNSTON
Practice Address - State:RI
Practice Address - Zip Code:02919-3228
Practice Address - Country:US
Practice Address - Phone:401-351-6200
Practice Address - Fax:401-351-6201
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2009-04-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
RIMD09787207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAAA48450OtherHARVARD PILGRIM HEALTH
050397249OtherUNITEDHEALTHCARE
050397249OtherWORKERS COMPENSTION
050397249OtherMULTIPLANS
050397249OtherPEQUOT PLUS HEALTH PLANS
103714900OtherU.S. DEPT. OF LABOR-WC
RI23922OtherNEIGHBORHOOD HEALTH PLANS
RI2723OtherBC BS OF RI
CD1829OtherRAILROAD MEDICARE
RI402836OtherBLUECHIP OF RI
R000315OtherTRICARE
0860497-002OtherCIGNA
7278316OtherAETNA
MA778764OtherTUFTS HEALTH PLANS
050397249OtherFIRST HLTH/COVENTRY/HCVM
RI9002723Medicaid
7278316OtherAETNA
MA778764OtherTUFTS HEALTH PLANS
050397249OtherWORKERS COMPENSTION