Individual
DR. JERRY L MOENCH
Active
Individual
DR. JERRY L MOENCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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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