Individual
DR. DOUGLAS R MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
25195 KELLY RD STE A, ROSEVILLE, MI 48066-4909
(586) 775-4594
(586) 775-4506
Mailing address
25195 KELLY RD STE A, ROSEVILLE, MI 48066-4909
(586) 775-4594
(586) 775-4506
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
0102202087
VA
207RC0001X
Clinical Cardiac Electrophysiology Physician
0102202087
VA
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
5101013212
MI
Other
Enumeration date
06/09/2005
Last updated
10/11/2024
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