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Individual
KEVIN EMMANUAL MOORE
Active
Individual
KEVIN EMMANUAL MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
288
OK
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
POD001181
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003116370B
—
GA
Enumeration date
06/14/2011
Last updated
02/01/2022
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