Individual
TIMOTHY MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3100 PLAZA PROPERTIES BLVD, COLUMBUS, OH 43219-1530
(614) 383-6000
(614) 383-6001
Mailing address
PO BOX 749495, ATLANTA, GA 30374-9495
(239) 432-8331
(813) 321-1296
Taxonomy
Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
35067263
OH
207RX0202X
Medical Oncology Physician
Primary
35067263
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000118593
ANTHEM BC/BS
OH
05
—
0835878
—
OH
01
—
3600169
UNITED HEALTHCARE
OH
Enumeration date
05/04/2006
Last updated
01/11/2023
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