DR. CLINTON T MOEN (NPI# 1063401297) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1063401297 |
Entity Type | Individual |
Full Name | DR. CLINTON T MOEN |
Credential | M.D. |
Practice Address |
2711 E 5th St Duluth MN 55812 |
Mailing Address |
2711 E 5th St Duluth MN 55812-1538 |
Practice Telephone | 2187240649 |
Mailing Telephone | 2187240649 |
Enumeration Date | 2005-10-20 |
Last Update Date | 2015-01-20 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 174400000X | Specialist | 25367 | WI | Other Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WI | 30451200 | 05 |
Street Address |
2711 E 5TH ST |
City | DULUTH |
State | MN |
Zip Code | 55812 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1942743950 | Thomas Anthony Olson | Specialist/Technologist | 1049 Ordean Court, 170 Sports & Health Center, Duluth, MN 55812 | 2016-11-22 |
1922457183 | Zen Eye Care Pllc | Optometrist | 2106 London Road, Duluth, MN 55812 | 2016-06-08 |
1295134088 | Charla Buxbaum | Specialist/Technologist | 1216 Ordean Ct. Sphc 170, University of Minnesota Duluth, Duluth, MN 55812 | 2014-08-18 |
1346473998 | Patricia A Trachte | Nurse Practitioner | 107 Ksc, Umd Quick Care, Duluth, MN 55812 | 2009-08-31 |
1003088543 | Arrowhead House Inc | Community Based Residential Treatment Facility, Mental Illness | 16 South 18th Avenue East, Duluth, MN 55812 | 2008-03-25 |
1073689295 | Nicolle Marie Nicklas | Nurse Anesthetist, Certified Registered | 219 Garden St., Duluth, MN 55812 | 2006-11-28 |
1346328762 | Timothy Patrick Stratton | Pharmacist | 386a Kirby Plaza, 1208 Kirby Drive, Duluth, MN 55812 | 2006-11-02 |
1316960701 | Questar Duluth, Inc | Specialist | 1527 London Road, Duluth, MN 55812 | 2006-07-26 |
1124016563 | Christine Aas-larson | Nurse Practitioner | 1502 London Road, Suite 102, Duluth, MN 55812 | 2005-10-10 |
1831731645 | Krystal Mueller | Behavior Technician | 1522 E Superior St, Duluth, MN 55812 | 2019-10-14 |
Find all providers in zip 55812 |
Taxonomy Code | 174400000X |
Grouping | Other Service Providers |
Classification | Specialist |
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992327415 | Julie Baker | Specialist | 907 W Central Entrance, Duluth, MN 55811-5469 | 2020-05-07 |
1942510904 | Amanda Rose Kerola | Specialist | 2814 Minnesota Ave, Duluth, MN 55802-2526 | 2010-10-08 |
1639323827 | Elegant Touch Massage Therapy | Specialist | 2590 Peachtree Industrial Blvd Ste D, Duluth, GA 30097-3405 | 2008-11-14 |
1003089418 | Gwinnett Multi Specialty Group LLC | Specialist | 3840 Peachtree Industrial Boulevard, Duluth, GA 30096-4847 | 2008-04-07 |
1790954279 | Generations Health Care Initiative Inc | Specialist | 5 N 3rd Ave W, Suite 310, Duluth, MN 55802 | 2008-02-28 |
1912067877 | Barbara Joy Bergstrom | Specialist | 4505 W Superior St, Duluth, MN 55807-2728 | 2006-12-11 |
1851474506 | Heide's Mastectomy Services of Duluth. | Specialist | 701 1/2 North 6th Ave. East, Duluth, MN 55805-1333 | 2006-10-23 |
1447342241 | Advanced Prosthetics Inc | Specialist | 3540 Duluth Park Lane, Suite 230, Duluth, GA 30096 | 2006-09-29 |
1316960701 | Questar Duluth, Inc | Specialist | 1527 London Road, Duluth, MN 55812 | 2006-07-26 |
1932125820 | Northland Urology Asso. P.a. | Specialist | 1000 E 1st St Ste 306, Duluth, MN 55805-2297 | 2006-07-14 |
Find all providers in DULUTH |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.