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Individual

JOSEPH MORIARTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
13060 ISLE DR, BAXTER, MN 56425-8331
(218) 828-2880
Mailing address
523 N 3RD ST, BRAINERD, MN 56401-3054
(218) 829-2861

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
40765
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
640018300
MN
Enumeration date
01/06/2006
Last updated
01/08/2016
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