Individual
WALTER PARKER MOORE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
401 N 9TH ST, BISMARCK, ND 58501-4530
(701) 712-4500
Mailing address
401 N 9TH ST, BISMARCK, ND 58501-4530
(701) 712-4500
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
H6450
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
139546901
—
TX
Enumeration date
11/29/2005
Last updated
06/15/2023
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