Individual
DR. DOUGLAS L. MOEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2700 STATE ST, BISMARCK, ND 58503-0669
(701) 530-6000
(701) 530-6430
Mailing address
2700 STATE ST, BISMARCK, ND 58503-0669
(701) 712-4500
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5348
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080174392
MEDICARE RAILROAD
ND
05
—
15348
—
ND
Enumeration date
05/17/2006
Last updated
06/15/2023
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