Individual
FREDERICK ERNEST MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
189 COUNTY PARK RD., YANCEYVILLE, NC 27379
(336) 694-4129
(336) 694-7030
Mailing address
189 COUNTY PARK RD., YANCEYVILLE, NC 27379
(336) 694-4129
(336) 694-7030
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
30217
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30217
NC MEDICAL LICENSE NUMBER
NC
05
—
8960528
—
NC
Enumeration date
12/12/2006
Last updated
03/07/2023
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