Individual
MARY D MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1000 HOUGHTON AVE, SAGINAW, MI 48602-5303
(989) 746-7500
(989) 746-7752
Mailing address
1000 HOUGHTON AVE, SAGINAW, MI 48602-5303
(989) 746-7500
(989) 746-7752
Taxonomy
Speciality
Code
Description
License number
State
2080P0216X
Pediatric Rheumatology Physician
Primary
4301080845
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3503906282
BCBS
—
05
—
4440356
—
MI
Enumeration date
03/17/2006
Last updated
03/30/2021
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