Moen, Andrew

Moen, Andrew is an individual health care provider with primary practice located at 1027 Washington Ave , Detroit Lakes MN 56501-3409. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Moen, Andrew can be contacted via phone (218) 847-5611.

Contact Information

Primary practice address
1027 Washington Ave Detroit Lakes MN 56501-3409
Phone: (218) 847-5611
Fax: (218) 847-0881
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X TP-169 Minnesota
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 844 Minnesota

Profile Details

NPI number 1073843587
LBN Legal business name Moen, Andrew
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 5th, 2010
Last updated Dec 7th, 2011 - about 13 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1073843587 NPPES
Minnesota MEDICAID 1073843587

Popular Providers