Individual
DR. NICHOLAS SIMON ALEXANDER MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
30 N MARIO CAPECCHI DR RM 3N100, SALT LAKE CITY, UT 84112
(801) 581-2121
Mailing address
30 N MARIO CAPECCHI DR RM 3N100, SALT LAKE CITY, UT 84112
(801) 581-2121
Taxonomy
Speciality
Code
Description
License number
State
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
14209922-1205
UT
390200000X
Student in an Organized Health Care Education/Training Program
MED-RES-LIC-113361
MT
Other
Enumeration date
07/18/2022
Last updated
03/27/2025
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