Individual
ELIZABETH A MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1918 RANDOLPH RD, SUITE 350, CHARLOTTE, NC 28207-1100
(704) 384-1750
(704) 384-1748
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-1750
(704) 384-1748
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
9500899
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
N00890
—
SC
Enumeration date
05/17/2006
Last updated
10/28/2020
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