Individual
VICTORIA L MOYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
138 N DIXON RD, KOKOMO, IN 46901-4154
(765) 236-8282
Mailing address
138 N DIXON RD, KOKOMO, IN 46901-4154
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01055871A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000229465
ANTHEM
—
01
—
10784616
CAQH
—
05
—
200389350A
—
IN
Enumeration date
11/07/2005
Last updated
10/05/2022
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