Individual
THOMAS P. MORETTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
500 ARCADE AVE, SUITE 400, ELKHART, IN 46514-2477
(574) 522-2284
(574) 522-3952
Mailing address
710 N NILES AVE, SOUTH BEND, IN 46617-1924
(574) 647-1610
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10001037A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000634026
BCBS BMG ORTHOPEDIC TRAUMA
IN
05
—
300008492
—
IN
01
—
P01153860
RR MEDICARE
IN
Enumeration date
08/11/2008
Last updated
12/06/2017
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