Moe, Mark John

Moe, Mark John is an individual health care provider with primary practice located at 811 2Nd St Se Ste A , Little Falls MN 56345-3505. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Moe, Mark John can be contacted via phone (320) 631-7000.

Contact Information

Primary practice address
811 2Nd St Se Ste A Little Falls MN 56345-3505
Phone: (320) 631-7000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 46385 Minnesota

Profile Details

NPI number 1902821937
LBN Legal business name Moe, Mark John
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2006
Last updated Jul 18th, 2012 - about 12 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 1902821937 NPPES
Minnesota MEDICAID 779460600
Minnesota Other 879S1MO
Minnesota Other 132024C736
Minnesota Other 2145399
Minnesota Other 0406746
Minnesota Other HP43143
Minnesota Other NA9231041286
Minnesota Other A031

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