Provider Demographics
NPI:1932336393
Name:MOSS, CHAD MITCHELL (MD)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:MITCHELL
Last Name:MOSS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:410 42ND AVE N STE 400
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-3658
Mailing Address - Country:US
Mailing Address - Phone:615-329-7887
Mailing Address - Fax:
Practice Address - Street 1:832 WESTOVER DR STE 200
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-4843
Practice Address - Country:US
Practice Address - Phone:931-380-3033
Practice Address - Fax:931-388-3401
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-12
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD0000051230208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN103I022499Medicare UPIN