Individual
DONALD HALSTEAD MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1097 FLEDDERJOHN RD STE 1, CHARLESTON, WV 25314-4208
(304) 345-3627
(304) 346-4440
Mailing address
4605 MACCORKLE AVE SW, SOUTH CHARLESTON, WV 25309-1311
(304) 414-4800
(304) 414-4801
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
13276
WV
207Q00000X
Family Medicine Physician
Primary
13276
WV
Other
Enumeration date
06/01/2005
Last updated
01/08/2021
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