Individual
CHARLES E MOORE II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4 E ROLLING CROSSROADS, 102, CATONSVILLE, MD 21228-6210
(410) 869-3344
(410) 869-3340
Mailing address
PO BOX 257, WEST FRIENDSHIP, MD 21794-0257
(410) 869-3344
(410) 869-3340
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
DOO35330
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MA280251100
—
MD
Enumeration date
01/23/2007
Last updated
07/25/2011
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