Individual
DILIP K. MOONKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
HENRY FORD HEALTH SYSTEM, 2799 WEST GRAND BOULEVARD, DETROIT, MI 48202
(313) 916-2436
Mailing address
HENRY FORD HEALTH SYSTEM, 2799 WEST GRAND BOULEVARD, DETROIT, MI 48202
(313) 916-2436
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
070509
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100H264400
BLUE CROSS-BLUE CROSS
—
05
—
336890010
—
MI
01
—
DM070509
CHAMPUS-CHAMPUS
—
Enumeration date
12/01/2006
Last updated
08/15/2012
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