Individual
DR. MICAH ROBERT MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
400 N JEFFERSON ST, LEWISBURG, WV 24901
(304) 645-3220
(304) 647-1273
Mailing address
1320 MAPLEWOOD AVE, RONCEVERTE, WV 24970-8016
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3323
WV
208D00000X
General Practice Physician
3323
WV
Other
Enumeration date
06/18/2017
Last updated
01/13/2021
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