Individual
SAMUEL MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 HARVARD ST SE, MINNEAPOLIS, MN 55455-0363
(612) 273-8383
Mailing address
3028 CAVELL AVE N, NEW HOPE, MN 55427-2423
(507) 351-6577
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2893
MN
Other
Enumeration date
07/14/2023
Last updated
10/10/2023
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