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Individual
DR. MARK A MOEN
Active
Individual
DR. MARK A MOEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
441
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0311120001
CIGNA MEDICARE SERVICE
ND
01
—
450433379000
WORKERS SAFETY AND COMP
ND
05
—
60342
—
ND
01
—
800441
ND VISION SERVICES
ND
01
—
8844
BS OF NORTH DAKOTA
ND
01
—
CI2649
PALMETTO GBA - RAILROAD MEDICARE
ND
Enumeration date
09/15/2006
Last updated
05/15/2008
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