Provider Demographics
NPI:1952309684
Name:MOSKOVITZ, PETER ALAN (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:ALAN
Last Name:MOSKOVITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 WASHINGTON CIR NW
Mailing Address - Street 2:SUITE 404
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-2356
Mailing Address - Country:US
Mailing Address - Phone:202-333-2820
Mailing Address - Fax:202-833-1410
Practice Address - Street 1:3 WASHINGTON CIR NW
Practice Address - Street 2:SUITE 404
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-2356
Practice Address - Country:US
Practice Address - Phone:202-333-2820
Practice Address - Fax:202-833-1410
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD4949174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC44290001OtherBLUE CROSS BLUE SHIELD
DC44290001OtherBLUE CROSS BLUE SHIELD
DCMO175892Medicare ID - Type Unspecified