Individual
DR. GARY L MOORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2213 CHERRY ST, TOLEDO, OH 43608-2603
(419) 251-4204
Mailing address
2942 SHORELAND AVE, TOLEDO, OH 43611-1248
(419) 729-5785
(419) 729-4028
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
34003175
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000360664
BCBS
OH
01
—
000000377156
BCBS
—
05
—
0510343
—
OH
05
—
114734293
—
MI
05
—
114808628
—
MI
01
—
P00280770
RAILROAD MEDICARE
—
Enumeration date
05/27/2005
Last updated
11/15/2007
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