Individual
DR. ANN MARGARET MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
800 BROADWAY, SUITE 115, FORT WAYNE, IN 46802-2149
(260) 425-3636
Mailing address
800 BROADWAY, SUITE 115, FORT WAYNE, IN 46802-2149
(260) 425-3636
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
02002191A
IN
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
02002191A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000283793
ANTHEM
IN
05
—
200290130
—
IN
Enumeration date
01/17/2006
Last updated
03/22/2011
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