Individual
MR. MICHAEL F MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
604 DIVISION ST, CLARKS SUMMIT, PA 18411-1928
(570) 319-6933
Mailing address
604 DIVISION ST, CLARKS SUMMIT, PA 18411-1928
(570) 319-6933
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD022692E
PA
2086S0129X
Vascular Surgery Physician
Primary
MD022692E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007164390005
—
PA
Enumeration date
06/23/2006
Last updated
07/25/2016
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