Provider Demographics
NPI:1528642535
Name:MOSES, SCOTT JOHN (MB BCH BAO)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:JOHN
Last Name:MOSES
Suffix:
Gender:M
Credentials:MB BCH BAO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:APARTMENT 2
Mailing Address - Street 2:14 A SADDLE ROAD, MARAVAL
Mailing Address - City:PORT-OF-SPAIN
Mailing Address - State:PORT-OF-SPAIN
Mailing Address - Zip Code:150123
Mailing Address - Country:TT
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:55 FRUIT STREET
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114
Practice Address - Country:US
Practice Address - Phone:617-726-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-06
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program