Moody, Gary A.

Moody, Gary A. is an individual health care provider with primary practice located at 1285 Nininger Rd , Hastings MN 55033-1086. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Moody, Gary A. can be contacted via phone (651) 480-4200.

Contact Information

Primary practice address
1285 Nininger Rd Hastings MN 55033-1086
Phone: (651) 480-4200
Fax: (651) 480-4306
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 22698 Minnesota

Profile Details

NPI number 1356310148
LBN Legal business name Moody, Gary A.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 15th, 2006
Last updated Jul 30th, 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 1356310148 NPPES
Minnesota Other 30229200 MEDICAID WI
Minnesota Other 66-07826 MEDICAID WI
Minnesota Other HP11055 MEDICAID WI
Minnesota Other 01-11650 MEDICAID WI
Minnesota Other 102582 MEDICAID WI
Minnesota MEDICAID 760387800 MEDICAID WI
Minnesota Other 30229200 MEDICAID WI
Minnesota Other NA9140186005 MEDICAID WI
Minnesota Other 080194898 MEDICAID WI
Minnesota Other 472S5M0 MEDICAID WI

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