Individual
TIMOTHY S MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1501 SAN PEDRO DR SE, ALBUQUERQUE, NM 87108-5153
(505) 265-1711
Mailing address
3400 SPRUCE ST, 5 WHITE, PHILADELPHIA, PA 19104-4238
(215) 662-4000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD2013-0095
NM
207RR0500X
Rheumatology Physician
Primary
MD458069
PA
Other
Enumeration date
04/11/2010
Last updated
06/07/2016
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