Individual
DR. JERRY L MOENCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4520 W 69TH ST, SIOUX FALLS, SD 57108-8148
(605) 977-5000
(605) 977-5377
Mailing address
PO BOX 5009, SIOUX FALLS, SD 57117-5009
(605) 977-5000
(605) 977-5377
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
1548
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0009604
SD BCBS
SD
05
—
1106195
—
IA
01
—
1548
DAKOTACARE
SD
01
—
165027
UCARE
—
01
—
24681
HEALTH PARTNERS
—
01
—
538R5MO
MN BCBS - PLAN 538R2NO
MN
05
—
6001200
—
SD
01
—
92589MO
MN BCBS - PLAN 91057NO
MN
01
—
931451029038
PREFERRED ONE
—
Enumeration date
05/17/2006
Last updated
03/24/2008
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