Individual
DR. MARK JOHN MOE
Active
Individual
DR. MARK JOHN MOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
46385
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0406746
MEDICA
—
01
—
132024C736
UCARE MINNESOTA
MN
01
—
2145399
AMERICA'S PPO
—
05
—
779460600
—
MN
01
—
879S1MO
BCBS OF MINNESOTA
MN
01
—
A031
TRICARE
MN
01
—
HP43143
HEALTH PARTNERS
—
01
—
NA9231041286
PREFERRED ONE
—
Enumeration date
07/12/2006
Last updated
07/18/2012
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