Individual
DR. GARY A. MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1285 NININGER RD, HASTINGS, MN 55033-1086
(651) 480-4200
(651) 480-4306
Mailing address
1285 NININGER RD, HASTINGS, MN 55033-1086
(651) 480-4200
(651) 480-4306
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22698
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-11650
MEDICA
MN
01
—
080194898
RAILROAD MEDICARAE
MN
01
—
102582
UCARE MINNESOTA
MN
01
—
30229200
MEDICAID WI
MN
01
—
472S5M0
BLUE CROSS
MN
01
—
66-07826
MEDICA URGENT CARE
MN
05
—
760387800
—
MN
01
—
HP11055
HEALTH PARTNERS
MN
01
—
NA9140186005
PREFERRED ONE
MN
Enumeration date
03/15/2006
Last updated
07/30/2012
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