Moen, Michael L

Moen, Michael L is an individual health care provider with primary practice located at 1235 E Cherokee St , Springfield MO 65804-2203. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Moen, Michael L can be contacted via phone (417) 820-2115.

Contact Information

Primary practice address
1235 E Cherokee St Springfield MO 65804-2203
Phone: (417) 820-2115
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 2005012338 Missouri

Profile Details

NPI number 1619937893
LBN Legal business name Moen, Michael L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 23rd, 2006
Last updated Feb 13th, 2014 - 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 1619937893 NPPES
Missouri Other P01034638 MCR RR
Missouri MEDICAID 1619937893 MCR RR
Missouri Other 440552485 MCR RR

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