MR. GARY BLAIR MOSS MD
Allergy and Immunology
Virginia Beach, Virginia
Provider NPI: 1588665137
Provider Information:MR. GARY BLAIR MOSS MD
Practice Location:
1704 SIR WILLIAM OSLER DR SUITE 300 VIRGINIA BEACH, VA 23454 US
Tel: 757-481-4383 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 207K00000X | Physicians Allergy & Immunology | VA | 0101049940 |
Other Provider Identifiers:
| Issuer | Number | State | Type |
|---|---|---|---|
| ANTHEM | 322700 | VA | 01 |
| MEDICARE GROUP # | C01592 | VA | 01 |
| OPTIMA/SENTARA | 56572 | VA | 01 |
| RAILROAD MEDICARE GROUP # | CF1969 | 01 | |
| MAMSI | 348140 | VA | 01 |
| GROUP NPI# | 1326022880 | 01 | |
| 5803071 | VA | 05 | |
| INDIVIDUAL NPI# | 1588665137 | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
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