Individual
EDWARD M MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
561 FAIRTHORNE AVE, PHILADELPHIA, PA 19128-2412
(215) 487-4071
(215) 483-8187
Mailing address
1 GOLF VIEW DR, VOORHEES, NJ 08043-1428
(856) 795-5114
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD048178L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001571971
—
PA
Enumeration date
09/28/2006
Last updated
07/08/2007
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