Provider Demographics
NPI:1942208624
Name:MOZER, MARK ALAN (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:ALAN
Last Name:MOZER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:205 W R D MIZE RD
Mailing Address - Street 2:SUITE 304
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64014-2518
Mailing Address - Country:US
Mailing Address - Phone:816-228-4770
Mailing Address - Fax:816-228-1156
Practice Address - Street 1:205 W R D MIZE RD
Practice Address - Street 2:SUITE 304
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64014-2518
Practice Address - Country:US
Practice Address - Phone:816-228-4770
Practice Address - Fax:816-228-1156
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2012-08-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MOR2P28208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
1205145OtherUNITED HEALTH CARE
204401OtherFAMILY HEALTH PARTNERS
4201077OtherAETNA
MO203047105Medicaid
17646020OtherBLUE CROSS/BLUE SHIELD
305740OtherFIRST GUARD
204400OtherFAMILY HEALTH PARTNERS