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Individual

DR. GLENNDALE MOORE

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2949 NEW BERN AVE, SUITE 112-A, RALEIGH, NC 27610-1248
(919) 231-3614
(919) 212-9029
Mailing address
PO BOX 28510, RALEIGH, NC 27611-8510
(919) 231-3614
(919) 212-9029

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
24609
NC

Other

Enumeration date
04/10/2006
Last updated
07/08/2007
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