Moench, Jerry L

Moench, Jerry L is an individual health care provider with primary practice located at 4520 W 69Th St , Sioux Falls SD 57108-8148. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Moench, Jerry L can be contacted via phone (605) 977-5000.

Contact Information

Primary practice address
4520 W 69Th St Sioux Falls SD 57108-8148
Phone: (605) 977-5000
Fax: (605) 977-5377
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 1548 South Dakota

Profile Details

NPI number 1619920311
LBN Legal business name Moench, Jerry L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 17th, 2006
Last updated Mar 24th, 2008 - about 16 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 1619920311 NPPES
Other 165027 UCARE
MEDICAID 6001200 UCARE
MEDICAID 1106195 UCARE
Other 24681 UCARE
Other 92589MO UCARE
Other 931451029038 UCARE
Other 0009604 UCARE
Other 538R5MO UCARE
Other 1548 UCARE

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