Basic Information
| Provider Information | |||||||||
| NPI: | 1407995806 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MOSKAL | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 130 HUNTERS STATION WAY | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | SELLERSBURG | ||||||||
| State: | IN | ||||||||
| PostalCode: | 47172 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8122484789 | ||||||||
| FaxNumber: | 8122484773 | ||||||||
| Practice Location | |||||||||
| Address1: | 130 HUNTERS STATION WAY | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | SELLERSBURG | ||||||||
| State: | IN | ||||||||
| PostalCode: | 47172 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8122484789 | ||||||||
| FaxNumber: | 8122484773 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/05/2007 | ||||||||
| LastUpdateDate: | 08/05/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 01049141 | IN | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.