Individual
ELAINE K MOEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10590 N MERIDIAN ST, INDIANAPOLIS, IN 46290-1028
(317) 338-6666
Mailing address
10590 N MERIDIAN ST, CARMEL, IN 46290-1028
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
01048322A
IN
207RI0011X
Interventional Cardiology Physician
Primary
01048322A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200178300
—
IN
Enumeration date
03/10/2006
Last updated
07/26/2022
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