Individual
FRITZ MOISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 WAKEFIELD TRCE, LOUISVILLE, KY 40245-5143
(502) 245-0445
Mailing address
200 WAKEFIELD TRCE, LOUISVILLE, KY 40245-5143
(502) 774-4401
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
29997
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000381974
ANTHEM FOR NICC
KY
01
—
200107170
ANTHEM INDIANA MEDICAID- NORTON ICC
IN
01
—
200107170
HEALTHY INDIANA PLAN- NORTON IMMEDIATE CARE CENTER
KY
05
—
200107170
—
IN
01
—
P00449265
RRMCR
KY
Enumeration date
04/19/2006
Last updated
03/19/2025
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