Individual
AMANDA M MOEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454-1450
(612) 365-6777
(612) 365-8021
Mailing address
200 UNIVERSITY AVE E, SAINT PAUL, MN 55101-2507
(651) 720-2803
(651) 229-1718
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
107634
MN
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
58414
MN
Other
Enumeration date
04/01/2009
Last updated
04/04/2019
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