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NPI Code Detail

MEDICARE: TIBERIU GHEORGHE MOGA MD

MEDICARE: TIBERIU GHEORGHE MOGA 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
1207RG0100XGastroenterology Physician01087755AIN
2390200000XStudent in an Organized Health Care Education/Training Program
3207R00000XInternal Medicine Physician01087755AIN

General Provider Information

NPI Number : 1225491673
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIBERIU GHEORGHE MOGA MD
Provider Business Mailing Address
First Line : 250 N SHADELAND AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46219-4959
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 550 S LANDMARK AVE
Second Line :
City : BLOOMINGTON
State : IN
Zip : 47403-3239
Country : US
Telephone Number : 812-333-5973
Fax Number : 812-330-3681
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2016
Last Update Date : 12/05/2025

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Directions to “ TIBERIU GHEORGHE MOGA MD” Practice Location

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