Individual
DR. MARTHA JANE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD-MPH
Contact information
Practice address
3223 E PALMER WASILLA HWY STE 4, WASILLA, AK 99654-7277
(907) 631-6300
(907) 631-6314
Mailing address
3223 E PALMER WASILLA HWY STE 4, WASILLA, AK 99654-7277
(907) 631-6300
(907) 631-6314
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
3944
AK
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
6678
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MD8920
—
AK
Enumeration date
09/20/2006
Last updated
07/30/2024
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