Individual
DR. ANGELA SUE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
3510 N RIDGE ROAD, SUITE 500, WICHITA, KS 67205
(316) 881-8180
(316) 881-8329
Mailing address
3510 N RIDGE ROAD, SUITE 500, WICHITA, KS 67205
(316) 881-8180
(316) 881-8239
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0534062
KS
207Q00000X
Family Medicine Physician
47165
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1184864076
NPI
—
05
—
200639670A
—
KS
Enumeration date
03/05/2009
Last updated
12/27/2023
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