DR. GLENN D MOAK (NPI# 1215079884) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1215079884 |
Entity Type | Individual |
Full Name | DR. GLENN D MOAK |
Credential | M.D. |
Practice Address |
4339 Royal Pine Blvd Indianapolis IN 46250-2277 |
Practice Telephone | 3178491617 |
Mailing Telephone | 3178491617 |
Enumeration Date | 2007-02-12 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
01019311A | IN | Allopathic & Osteopathic Physicians |
Street Address |
4339 ROYAL PINE BLVD |
City | INDIANAPOLIS |
State | IN |
Zip Code | 46250-2277 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1861037004 | Angela L Davis | Pharmacist | 8520 Bash St, Indianapolis, IN 46250 | 2019-11-12 |
1710455738 | Physicians Wellness Associates LLC | Family Medicine | 4735 Statesmen Drive, Suite C, Indianapolis, IN 46250 | 2018-11-07 |
1891222584 | Confidential Drug LLC | Pharmacy | 8520 Bash St Ste D, Indianapolis, IN 46250 | 2017-05-12 |
1659813590 | Occupational Health Centers of The Southwest Pa | Clinic/Center | 8257 Center Run Rd, Indianapolis, IN 46250 | 2016-11-09 |
1194275669 | Lucina Treatment Center, LLC | Internal Medicine | 8140 Castleton Rd, Indianapolis, IN 46250 | 2016-10-09 |
1609126150 | Joseph Lee Deck | Physical Therapist | 7400 Jewel Lane, Indianapolis, IN 46250 | 2012-09-12 |
1447508254 | Choices Coordinated Care Solutions, Inc. | Clinic/Center | 7941 Castleway Drive, Indianapolis, IN 46250 | 2012-08-28 |
1568719854 | Lynda L. Blackwelder, LLC | Marriage & Family Therapist | 4735 Statesmen Dr., Suite A, Indianapolis, IN 46250 | 2012-08-06 |
1972859452 | Courtney B. Cortez | Nurse Practitioner | 12400 N Meridian Ste 100, Suite 500, Indianapolis, IN 46250 | 2012-08-02 |
1861761934 | Kb Medical, Inc. | Durable Medical Equipment & Medical Supplies | 8455, Castlewood Drive, Suite J, Idianapolis, IN 46250 | 2011-12-20 |
Find all providers in zip 46250 |
Taxonomy Code | 2085R0202X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Radiology |
Specialization | Diagnostic Radiology |
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1598235566 | A Mri, LLC | Radiology | 7301 N Shadeland Ave Ste 1d, Indianapolis, IN 46250-2085 | 2018-12-03 |
1992138804 | George Byington Pratt IIi | Radiology | 9015 Crystal Lake Drive, Indianapolis, IN 46240 | 2013-08-14 |
1922340439 | Ted Alexander Seltman | Radiology | 550 University Blvd Rm 663, Indianapolis, IN 46202-5149 | 2013-03-22 |
1386919488 | Paul Joseph Niziolek | Radiology | 714 N Senate Ave Ste 100, Indianapolis, IN 46202 | 2012-03-21 |
1770862328 | Oscar Danilo Rosales | Radiology | 1001 W 10st, Wishard Hospital West Building M200, Indianapolis, IN 46202 | 2011-08-15 |
1326362120 | Jaimie M. Howell | Radiology | 714 N Senate Blvd., Suite 100, Indianapolis, IN 46202-3297 | 2010-03-23 |
1558525535 | Joel A Yalowitz | Radiology | 3907 Guilford Ave, Indianapolis, IN 46205-2827 | 2008-07-18 |
1891958757 | George Louis Trilikis | Radiology | 550 N University Blvd Room 0641, Dept of Radiology In University School of Medicine, Indianapolis, IN 46202 | 2008-07-09 |
1366604134 | Ian Wong | Radiology | 924 Fayette St, Indianapolis, IN 46202-3019 | 2008-07-01 |
1780845941 | Megan Beth Marine | Radiology | 550 University Blvd Rm 641, Indianapolis, IN 46202-5149 | 2008-06-20 |
Find all providers in INDIANAPOLIS |
City | INDIANAPOLIS |
Zip Code | 46250 |
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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.