Moen, Mark A

Moen, Mark A is an individual health care provider with primary practice located at 404 Hwy 2 East , Devils Lake ND 58301-0130. He recently has only one registered license in Eye and Vision Services Providers / Corneal and Contact Management, which is considered as his primary health care specialty. Moen, Mark A can be contacted via phone (701) 662-4085.

Contact Information

Primary practice address
404 Hwy 2 East Devils Lake ND 58301-0130
Phone: (701) 662-4085
Fax: (701) 662-6685
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Corneal and Contact Management 152WC0802X 441 North Dakota

Profile Details

NPI number 1124124623
LBN Legal business name Moen, Mark A
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 15th, 2006
Last updated May 15th, 2008 - about 17 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 1124124623 NPPES
North Dakota Other 450433379000 WORKERS SAFETY AND COMP
North Dakota Other 800441 WORKERS SAFETY AND COMP
North Dakota Other 8844 WORKERS SAFETY AND COMP
North Dakota Other CI2649 WORKERS SAFETY AND COMP
North Dakota Other 0311120001 WORKERS SAFETY AND COMP
North Dakota MEDICAID 60342 WORKERS SAFETY AND COMP

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