Individual
STEVEN J. MOOIBROEK
Active
Individual
STEVEN J. MOOIBROEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01054479A
IN
208000000X
Pediatrics Physician
01054479A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000196870
ANTHEM
IN
01
—
00002092742 02
UNITED
—
01
—
12184
PHYSICIANS HEALTH PLAN
IN
05
—
200330780
—
IN
01
—
3937240024
MEDICARE DMEPOS
IN
01
—
7559229
AETNA
—
Enumeration date
12/27/2005
Last updated
12/15/2022
Update your record
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