Individual
CARLOS MOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
8260 W INDIAN SCHOOL RD, STE 1 AND 2, PHOENIX, AZ 85033
(623) 846-7122
(623) 846-7027
Mailing address
PO BOX 32950, PHOENIX, AZ 85064
(602) 433-1822
(602) 246-7060
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3642
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
705329
—
AZ
01
—
84270
MEDICARE PIN #
—
Enumeration date
03/07/2006
Last updated
09/25/2012
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