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Contact Information

MARK A MOEN, OD
404 HWY 2 EAST
DEVILS LAKE, ND58301-0130
 Phone: 701-662-4085
 Fax: 701-662-6685
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Corneal and Contact Management

152WC0802X 41 Optometry
Indicates primary specialty

NPI Profile & details for MARK A MOEN · (Male)

NPI # 1124124623
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 09/15/2006
Last updated 05/15/2008 - About 18 years ago
Sole proprietor 1 No
Identifiers
  • ND License # 441
  • ND Medicaid 60342
  • ND Other 8844 BS OF NORTH DAKOTA
  • ND Other 0311120001 CIGNA MEDICARE SERVICE
  • ND Other 800441 ND VISION SERVICES
  • ND Other CI2649 PALMETTO GBA - RAILROAD MEDICARE
  • ND Other 450433379000 WORKERS SAFETY AND COMP
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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