Individual
DR. DEREK CECIL MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
29000 CENTER RIDGE RD, SUITE 150, WESTLAKE, OH 44145-5293
(440) 827-5566
(440) 827-5573
Mailing address
156 SOMERSET LN APT 12, AVON LAKE, OH 44012-3210
(620) 845-0116
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
05-37542
KS
Other
Enumeration date
06/26/2011
Last updated
10/20/2016
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