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NPI Code Detail

MEDICARE: DR. LUKE B MOSEMANN MD

MEDICARE: DR. LUKE B MOSEMANN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician01025415IN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1104819887
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LUKE B MOSEMANN MD
Provider Business Mailing Address
First Line : 260 S MAPLE ST
Second Line :
City : ORLEANS
State : IN
Zip : 47452-1724
Country : US
Telephone Number : 812-865-3350
Fax Number : 812-865-3814
Provider Business Practice Location Address
First Line : 260 S MAPLE ST
Second Line :
City : ORLEANS
State : IN
Zip : 47452-1724
Country : US
Telephone Number : 812-865-3350
Fax Number : 812-865-3814
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2005
Last Update Date : 08/01/2013

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Directions to “ DR. LUKE B MOSEMANN MD” Practice Location

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