Moise Mamouzette, M.D.

Individual provider Active NPI Obstetrics & Gynecology Physician · Christiansted, VI

NPI 1174516348 · NPPES record last updated Nov 17, 2011

Key facts

NPI
1174516348
Entity type
Individual (NPI type 1)
Primary specialty
Obstetrics & Gynecology Physician 207V00000X
License
1566 (VI)
Practice address
201-202 Estate Ruby
Christiansted, VI 00820
Phone
(340) 692-6263
Fax
(340) 778-4922
NPI assigned
Aug 23, 2005
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD 2008-0823NMMDObstetrics & Gynecology Physician
1566VIMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pine Ridge Indian Health Service Hospital Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD 2008-0823 NM
Obstetrics & Gynecology Physician 207V00000X 1566 VI Yes
Gynecology Physician 207VG0400X 225641 NY

Addresses

Primary practice location

201-202 Estate Ruby
Christiansted, VI 00820

Mailing address

PO Box 678
Christiansted, VI 00821-0678
Phone (340) 692-6263

Other providers in Christiansted, VI

All providers in Christiansted, VI · Obstetrics & Gynecology Physician in U.S. Virgin Islands

Sources for this page

Verify at the official NPI Registry.