Individual
SHAWN P MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
24838
OK
207T00000X
Neurological Surgery Physician
04-32207
KS
207T00000X
Neurological Surgery Physician
37505
AL
207T00000X
Neurological Surgery Physician
ME141772
FL
207T00000X
Neurological Surgery Physician
Primary
R6846
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
186639001
—
AR
05
—
200079770A
—
OK
05
—
200418720A
—
KS
01
—
24838
OKLAHOMA STATE ID#
OK
Enumeration date
05/24/2006
Last updated
04/13/2021
Update your record
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