# MARGARET MOEN MD PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255455887
- **Authorized official:** DR. MARGARET L MOEN MD (OWNER)
- **Authorized official phone:** (231) 935-8889

## Contact information

- **Practice address:** 457 MUNSON AVE, TRAVERSE CITY, MI 49686-3084
- **Practice address phone:** (231) 935-8889
- **Practice address fax:** (231) 935-0540
- **Mailing address:** 457 MUNSON AVE, TRAVERSE CITY, MI 49686-3084
- **Mailing address phone:** (231) 935-8889
- **Mailing address fax:** (231) 935-0540

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RS0012X | Sleep Medicine (Internal Medicine) Physician | MM050642 | MI | Yes |

## Other

- **Enumeration date:** 03/19/2007
- **Last updated:** 03/07/2023

## 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 |