Provider Demographics
NPI:1871920611
Name:MOI, MICHAEL (PA-C)
Entity type:Individual
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First Name:MICHAEL
Middle Name:
Last Name:MOI
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:30 SHELBURNE ROAD
Mailing Address - Street 2:STAMFORD HOSPITAL - CREDENTIALING & ENROLLMENT
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06094
Mailing Address - Country:US
Mailing Address - Phone:203-276-7387
Mailing Address - Fax:203-276-5501
Practice Address - Street 1:30 SHELBURNE RD
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-3628
Practice Address - Country:US
Practice Address - Phone:203-276-7387
Practice Address - Fax:203-276-5501
Is Sole Proprietor?:No
Enumeration Date:2013-10-10
Last Update Date:2023-06-28
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Provider Licenses
StateLicense IDTaxonomies
CT3007363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant