Provider Demographics
NPI:1477572998
Name:MOSS, ASHLEY J (MD)
Entity type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:J
Last Name:MOSS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9715 MEDICAL CENTER DR STE 230
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-6303
Mailing Address - Country:US
Mailing Address - Phone:301-279-2917
Mailing Address - Fax:
Practice Address - Street 1:9715 MEDICAL CENTER DR STE 230
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6303
Practice Address - Country:US
Practice Address - Phone:301-279-2917
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD64562208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDKJ50/89137001OtherCAREFIRST OF MD GBMC
MDS1390053OtherCAREFIRST REGIONAL GBMC