Individual
LAUREL ELAINE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1500 E MEDICAL CENTER DR, ANN ARBOR, MI 48109-5000
(734) 936-4000
Mailing address
3621 S STATE ST, ANN ARBOR, MI 48108-1633
(734) 647-5299
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
4301406836
MI
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
D39995
MD
208VP0014X
Interventional Pain Medicine Physician
D39995
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
060371600
—
MD
Enumeration date
05/17/2006
Last updated
02/10/2020
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