Moe, Gordon H

Moe, Gordon H is an individual health care provider with primary practice located at 2020 Capitol St Ne , Salem OR 97303-3244. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Moe, Gordon H can be contacted via phone (503) 399-2424.

Contact Information

Primary practice address
2020 Capitol St Ne Salem OR 97303-3244
Fax: (503) 375-7429
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X MD220855 Oregon

Profile Details

NPI number 1235172743
LBN Legal business name Moe, Gordon H
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2006
Last updated May 24th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235172743 NPPES
Oregon MEDICAID 220855
Oregon Other 020020350
Oregon Other CS4159

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