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Individual
DR. ANDREW E MOORE
Active
Individual
DR. ANDREW E MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
01027125A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000091687
ANTHEM PIN NUMBER
IN
05
—
100071440
—
IN
01
—
100194370
MEDICAID GROUP NUMBER
IN
01
—
1487680518
GROUP NPI
IN
01
—
340017159
MEDICARE RAILROAD
IN
Enumeration date
07/28/2006
Last updated
09/16/2014
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