Individual
DANIEL S. MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
HENRY FORD HEALTH SYSTEM, 2799 WEST GRAND BOULEVARD, DETROIT, MI 48202
(313) 916-9106
(313) 916-1249
Mailing address
HENRY FORD HEALTH SYSTEM, 2799 WEST GRAND BOULEVARD, DETROIT, MI 48202
(313) 916-9106
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301087116
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
490836510
—
MI
01
—
700H262220
BLUE CROSS-BLUE CROSS
—
01
—
DM087116
CHAMPUS-CHAMPUS
—
Enumeration date
07/13/2006
Last updated
04/05/2021
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