Individual
DR. SETH ALLEN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7950 N SHADELAND AVE, STE 350, INDIANAPOLIS, IN 46250-2691
(317) 621-6900
Mailing address
6626 E 75TH ST, STE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
11014230A
IN
207RG0100X
Gastroenterology Physician
Primary
01075414A
IN
207RG0100X
Gastroenterology Physician
57.020461
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01075414A
IN MEDICAL LICENSE
IN
05
—
201308340
—
IN
01
—
P01512507
MEDICARE RR
IN
Enumeration date
06/27/2008
Last updated
11/27/2023
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