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Individual

MATTHEW JAMES MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

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
363A00000X
Physician Assistant
003243
CT
363A00000X
Physician Assistant
Primary
5601008931
MI
363AM0700X
Medical Physician Assistant
003243
CT
363AS0400X
Surgical Physician Assistant
003243
CT

Other

Enumeration date
11/13/2014
Last updated
01/17/2025
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