Individual
DIAMOND MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
22 S GREEN STREET, BALTIMORE, MD 21201
(410) 328-8667
Mailing address
2159 OTTER CREEK CIR, HANOVER, MD 21076-2337
(601) 395-8928
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R251829
MD
Other
Enumeration date
01/19/2022
Last updated
12/07/2023
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