Individual
ELLEN CECILE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
14 WOODRIDGE DR, GREENBRIER, AR 72058-9583
(248) 549-0861
Mailing address
14 WOODRIDGE DR, GREENBRIER, AR 72058-9583
(248) 549-0861
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
4301038528
MI
208000000X
Pediatrics Physician
Primary
E-6324
AR
Other
Enumeration date
05/30/2006
Last updated
06/21/2016
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