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Organization
MARGARET MOEN MD PLLC
Active
Organization
MARGARET MOEN MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARGARET L MOEN MD (OWNER)
(231) 935-8889
Entity
Organization
Contact information
Practice address
457 MUNSON AVE, TRAVERSE CITY, MI 49686-3084
(231) 935-8889
(231) 935-0540
Mailing address
457 MUNSON AVE, TRAVERSE CITY, MI 49686-3084
(231) 935-8889
(231) 935-0540
Taxonomy
Speciality
Code
Description
License number
State
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
MM050642
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
$$$$$$$$$
SOCIAL SECURITY NUMBER
MI
01
—
1014033
NHP
MI
01
—
124729
PREFERRED CHOICES
MI
01
—
1302810101
BCBSM
MI
01
—
1336230481
INDIVIDUAL NPI
MI
01
—
2084N0400X
TAXONOMY
MI
05
—
4594192
—
MI
01
—
MM050642
STATE LICENSE
MI
01
—
P00116249
RR MEDICARE
MI
01
—
QMXPR0026631
MOLINA
MI
Enumeration date
03/19/2007
Last updated
03/07/2023
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