MEDICARE: MORIARITY /ALLEN, PSC

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
1	207V00000X	Obstetrics & Gynecology Physician

Other Identifiers

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

General Provider Information

NPI Number	:	1528175379
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MORIARITY /ALLEN, PSC

Provider Business Mailing Address
First Line	:	PO BOX 68952
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46268-0952
Country	:	US
Telephone Number	:	317-802-3100
Fax Number	:	317-870-0499

Provider Business Practice Location Address
First Line	:	2020 W 86TH ST
Second Line	:	SUITE #306
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46260-1969
Country	:	US
Telephone Number	:	317-872-2802
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	C WILLIAM ALLEN
Credential	:	MD
Telephone Number	:	317-870-2802

Provider Enumeration Date	:	08/25/2006
Last Update Date	:	10/23/2008

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Directions to “MORIARITY /ALLEN, PSC ” Practice Location

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