Organization
DAN MOEZZI MD PC
Active
Other names
Indian Wells Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAN H MOEZZI MD (PRESIDENT)
(575) 443-0339
Entity
Organization
Contact information
Practice address
2474 INDIAN WELLS RD, ALAMOGORDO, NM 88310-3831
(575) 443-0339
(575) 434-5624
Mailing address
2474 INDIAN WELLS RD, ALAMOGORDO, NM 88310-3831
(575) 443-0339
(575) 434-5624
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
95-302
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201017118
PRESBYTERIAN HEALTH CARE
NM
05
—
H1455
—
NM
01
—
NM004493
BLUE CROSS BLUE SHIELD
NM
Enumeration date
08/15/2006
Last updated
02/21/2010
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