Individual
DR. JAMES ROBERT MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2545 CHICAGO AVE, #512, MINNEAPOLIS, MN 55404-4522
(612) 813-6475
Mailing address
2545 CHICAGO AVE, #512, MINNEAPOLIS, MN 55404-4522
(612) 813-6475
Taxonomy
Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
23272
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
056300500
—
MN
Enumeration date
09/28/2006
Last updated
07/08/2007
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